Diabetic Neuropathy

Diabetic neuropathy is a common medical complication characterized by various types of nerve damage caused by diabetes mellitus (high blood sugar). The resulting symptoms often depend on which nerves are affected, and can include pain, tingling, numbness, muscle weakness, and even changes to involuntary functions like digestion and heart rate.

Presently, there is no known cure for diabetic neuropathy, but significant advances in management and treatment can effectively slow its progression and alleviate symptoms, drastically improving a person's quality of life.

What's Diabetic Neuropathy?

As explained earlier, diabetic neuropathy refers to nerve damage caused by prolonged high blood sugar levels associated with diabetes. Generally, the function of nerves is to transmit electrical impulses from the brain to other body parts; however, injuries like diabetic neuropathy can disrupt this process, leading to abnormal impulse transmission.

Also, besides transmitting impulses, our nerves function as a signaling system for body sensation and assist in body movement (controlling some specific functions like digestion, perspiration, and homeostasis maintenance). Imagine diabetes disrupting the delicate balance of these vital structures in the human body. Even without a detailed explanation, it's clear that the consequences can be serious and far-reaching.

Types of Diabetic Neuropathy

Diabetic neuropathy can be classified into different groups depending on the type of nerve that is affected. Types include:

• Peripheral Neuropathy: From the name “peripheral” this type often affects the nerves supplying the extremities, i.e., the feet, legs, and sometimes the hand.
• Autonomic Neuropathy: This type affects the human autonomic nervous system, which is responsible for reflex activities such as blood pressure, heart rate, bladder control, and digestion.
• Proximal Neuropathy: this is commonly called amyotrophy, and it impacts the nerves supplying the thighs, hips, buttocks, and shoulders, resulting in muscle weakness and pain.
• Focal Neuropathy/Mononeuropathy: focal neuropathy is the type that leads to sudden, localized dysfunction of a single nerve, causing muscle weakness and pain.

What Causes Diabetic Neuropathy?

Diabetes follows a progression, which means that in its earlier stages, it can often be effectively managed with lifestyle changes, medication, and regular monitoring. However, diabetes that's left untreated will result in hyperglycemia (high level of glucose in the blood), which can later advance to the point of damaging the nerves. According to the diabetic neuropathy ICD-10 classification edition, it's a disorder that is found within the E11 category, which particularly relates to insulin-independent diabetes mellitus (type 2).

Risk Factors for Diabetic Neuropathy

The number one risk factor for diabetic neuropathy is diabetes; people with diabetes are most likely to develop it. However, there are some other conditions as well that can expose someone to the risk of neuropathy:

• Smoking: “Smokers are liable to die young.” This is a warning you should likely have come across on cigarette packs. The complications that arise with smoking are numerous, some of which are ischemia, i.e., restriction or reduced blood flow to some body parts, which can result in difficulty in wound healing and damage to the nerves.
• Poor Blood Sugar Control: Abnormalities in blood sugar levels can increase the danger of every diabetes complication, including nerve damage.
• Renal Failure or Disease: People with diabetes mostly fall victim to renal infections. Once this occurs, toxins that should be excreted properly will be carried into the blood, supplying the nerves, thus resulting in nerve damage.
• Body Weight: A body mass index of 25 and above is another factor that may enhance the risk of diabetic neuropathy.

Diabetic Neuropathy Symptoms

Diabetic neuropathy symptoms may vary, depending on the type and severity of nerve damage that occurs. Generally, common manifestations include:

• Tingling or numbness in the extremities, especially the feet and hands.
• Increased pain sensitivity along with a burning sensation.
• Muscle weakness
• Difficulty in the healing of foot or leg ulcers.
• Total loss of sensation in the feet.

Overall, these symptoms not only affect the physical well-being of individuals but also contribute to emotional distress and a diminished quality of life.

Diagnosis for Diabetic Neuropathy

Foot examination is the most commonly adopted diagnosis method for diabetes neuropathy in Türkiye. During this procedure, the provider will observe the feet thoroughly to check if there are sores (ulcers), blisters, or injuries. Also, the feet may be examined with special instruments to check for sensitivity.

In some cases too, they may perform a nerve conduction study, and if the provider detects nerve damage, you may have an electromyogram (EMG), the test used for measuring electrical activities or nerve responses.

Complications of Diabetic Neuropathy

Complications that may develop from this condition include:

• Hypoglycemia Unawareness: Hypoglycemia usually results in shakiness, a fast heartbeat, and excessive sweating. However, people suffering from autonomic neuropathy may not experience such.
• Infection of the Urinary Tract: Damage to the nerve may cause urinary tract infection or incontinence (inability to urinate or control the muscles that release urine).
• Increased or Decreased Sweating: Diabetes neuropathy can also impact the sweat glands, thereby making it difficult for the body to regulate temperature.
• Rapid Decrease in Blood Pressure: Blood pressure regulation may be tampered with, especially if it's autonomic neuropathy. The affected individual can experience a sharp pressure drop, which may then result in lightheadedness and fainting.

Diabetic Neuropathy Treatment

Diabetic neuropathy treatment has been a major issue of concern for a very long time. However, there's currently no exact cure for diabetic neuropathy, but you can prevent or slow its progression. This is mostly done in two ways: by keeping your blood sugar healthy and by taking proper care of your feet.

Blood Sugar Management

Blood sugar levels can be checked using an instrument known as a glucometer. A glucometer is a portable device that can be possessed at home, because having it will make things easier. So if you discover that your blood sugar is higher than normal, there may be a need for changes in your daily management, which can be additions or adjustments in medications, diets, or physical activity.

Foot Care

Foot problems are many, and most of them can be prevented by a thorough foot examination by a provider at least once a year. Moreover, there are some things you can do independently without the help of any health care practitioners that will prevent the risk of this condition: trimming your nails, putting on clean and dry socks, wearing cushioned shoes that fit well, regular foot observation, etc.

Diabetic neuropathy remains a complex medical condition that arises from elevated blood sugar. As a result of this, you're more likely to develop it if you cannot properly manage your blood sugar.

Diabetic neuropathy is a serious but manageable condition. By partnering with your physician, committing to efficient blood sugar control, and taking meticulous care of your feet, you can successfully manage the condition and maintain a high quality of life. Patients can also consider joining a support group or seeking therapy to manage the emotional distress associated with chronic pain.

Medical Park offers multidisciplinary diabetes treatment where expert endocrinology specialists work closely with patients to ensure precise blood sugar regulation and stop further nerve damage. For those suffering from tingling or loss of sensation, our highly skilled neurologists utilize advanced diagnostic tools like EMG to accurately assess the extent of nerve involvement. Furthermore, we provide specialized preventative care through our orthopedics specialists to treat foot ulcers and preserve mobility, ensuring a holistic approach to patient wellness.