Diabetic neuropathy is the generic term for all diabetes-related nerve damage disorders. These disorders can affect our peripheral and autonomic nervous systems.
Peripheral nerves lie outside our brain and spinal cord. They extend through the limbs and to many sensory organs. Autonomic nerves control body movements that take place automatically such as heart beats, gland activity, and the workings of our intestines.
The most important thing to remember about diabetic neuropathy is that the best prevention, and primary means of slowing nerve damage progression, is good blood glucose control. However, about half of those who have diabetes develop neuropathy, and disciplined blood sugar monitoring does not guarantee immunity.
Cause and Risk FactorsThere is constant interaction between our blood vessels and our nerves – the health of one affects the health of the other – and glucose levels affect the functioning of both. We know that blood carries oxygen and nutrients to our nerves, and high blood sugar weakens blood vessel walls, impairing blood circulation. Elevated glucose also diminishes our nerves’ capacity to transmit signals.
Some other factors influence the development of diabetic neuropathy:
- Genetics. Thanks to our genetic inheritance some of us are more susceptible to nerve damage than others.
- Inflammation. Our immune system can mistake parts of our body for foreign organisms and attack them. This is called an autoimmune response, and it can cause our nerves to become inflamed. Chronic inflammation leads to nerve damage.
- Years having diabetes. Symptoms of neuropathy are most common in individuals who have had diabetes 25 years or more.
- Kidney problems. One complication of diabetes is kidney damage. Less effective kidneys may mean more toxins in the bloodstream, and toxins contribute to nerve injury.
- Alcohol abuse and smoking. Alcohol can wreak havoc on blood sugar levels, increasing the risk of neuropathy. Smoking is known to reduce blood flow in our extremities by narrowing and hardening the arteries.
Four Types of Neuropathy and SymptomsNot everyone with diabetic neuropathy experiences symptoms, and damage that occurs over time may not trigger symptoms until the injury is significant.
1. Peripheral neuropathy is the most common type of diabetic nerve damage. It may cause numbness or pain in the toes, feet, legs, hands, or arms. Other names for peripheral neuropathy are sensorimotor neuropathy and distal symmetric neuropathy. Symptoms include:
- Numbness, or lack of sensitivity to pain/temperature
- Burning, tingling, or prickling sensations
- Cramps and sharp pain
- High sensitivity to touch
- Reduced coordination and balance
- Hypoglycemia unawareness (not realizing your blood sugar levels are low)
- Drop in blood pressure after sitting or standing; increased heart rate
- Constipation; gastroparesis (stomach empties too slowly); trouble swallowing
- Bladder infections (bladder does not empty fully), incontinence, and sexual performance issues
- Sweat gland malfunction (no sweating, or profuse sweating)
- The eyes' pupils become less responsive to light changes; poor night vision
- Severe hip, leg, thigh, and buttock pain
- Weakened or atrophied thigh muscles
- Trouble standing from a seated position
- Possible abdominal swelling; weight loss
- Double vision, problems focusing, an ache behind one eye
- Bell’s palsy (paralysis on one side of the face)
- Severe pelvic or lower back pain
- Front thigh pain; pain at the inside of a foot or the outside of a shin
- Chest, stomach, or side pain
- Intense abdominal or chest pain (can be mistaken for appendicitis/heart attack)