Neuropathy – An Overview
The human nervous system consists of two parts, namely, the central nervous system and the peripheral nervous system. While the central nervous system comprises of the brain and the spinal cord, the peripheral nervous system helps transmit messages between the central nervous system and the rest of the body. The nerves are responsible for controlling numerous body functions like the perception of stimuli (sensory nerves), involuntary organ activity (autonomic nerves), and voluntary muscle movement (motor nerves). Neuropathy is a condition that occurs when the peripheral nerves are damaged or disrupted. It is also known as Peripheral Neuropathy for the same reason.
What is Diabetic Neuropathy?
Poor control of blood sugar, persisting over a long period of time, is one of the main causes of neuropathy, and prolonged exposure to high blood sugar levels can damage the nerves of the body, leading to a condition known as Diabetic Neuropathy. The higher the levels of blood sugar are the greater is the chance for an individual to develop neuropathy.
Since the longest nerve that goes from the spine to the toes is affected by high blood sugar, your feet will be affected first. One of the most common long-term complications of type 2 Diabetes, numbness in the feet, is also a common symptom of nerve damage. Neuropathy is common in individuals with type 2 diabetes for over 25 years; however, it may also occur in people having pre-diabetes.
Types of Diabetic Neuropathy
There are three types of diabetic neuropathy –
Peripheral Neuropathy: This condition causes damage to the peripheral nerves. Apart from affecting movement and muscle strength, the peripheral nerves are also responsible for sensing pain, touch, hot, and cold. Diabetic neuropathy in the peripheral nerves affects the feet and lower legs most, often leading to serious foot conditions that can result in ulcers, infection, and even foot amputation.
Autonomic Neuropathy: Autonomic neuropathy causes damage to the autonomic nerves that are responsible for controlling the heartbeat, blood pressure, urination, sexual function, sweating, and digestion.
Focal Neuropathy: Focal neuropathy is a type of diabetic neuropathy that affects just one nerve, usually in the foot, wrist, or thigh. Focal neuropathy may also affect the nerves of the chest, back as well as those controlling the eyes muscles. This is a condition that usually just happens suddenly.
Signs of Diabetic Neuropathy
One of the most important factors that you need to keep in mind is that some individuals who are affected with diabetic neuropathy may not show symptoms of nerve damage. However, some individuals may show symptoms like pain, numbness, or tingling in the extremities. Diabetic neuropathy affects the feet first and then slowly progresses upwards. When the feet are affected, individuals will not only feel numbness but also pain and injuries.
The numbness caused due to this condition also makes it difficult to sense a cut or injury, thereby increasing the risk of infections and amputation. Adding to this, the condition can also change the shape of the feet, deforming them to such an extent where regular shoes can no longer fit. Diabetic neuropathy can also lead to dryness and damage of the skin, interference with circulation, and cause calluses and ulcers on the feet.
How is Diabetic Neuropathy Diagnosed?
If you notice any symptoms of diabetic neuropathy, consult a doctor immediately. They will start with a physical examination and note the details of your symptoms along with your medical history. During the check-up, the doctor will check your level of sensitivity to temperature, touch, muscle tone, blood pressure, and heart rate. Your doctor might also perform the filament test, which helps in assessing the sensitivity in your feet. The filament test uses a nylon fibre to check the limbs for sensation loss. In addition to this, a tuning fork may be used to check for the vibration threshold. Along with the filament test, your doctor may also check for reflexes in the ankle.
How is Diabetic Neuropathy Treated?
There is no dedicated treatment for diabetic neuropathy. However, the progression of the condition can be slowed down. Keeping your blood sugar levels in control is the best way of decreasing or slowing down the development of diabetic neuropathy. With this, a few symptoms may also be dismissed. Working out regularly, quitting smoking, and other such lifestyle changes are also quite effective in helping slow down the progression of diabetic neuropathy. Although there are a few medicines available to cure the pain caused by the condition, make sure you consult your doctor regarding potential side effects.
Managing Complications
Based on the type of diabetic neuropathy, your doctor may suggest medicines, lifestyle changes, and therapies that can help manage the symptoms and reduce the risk of complications. For example, if you have digestion problems because of neuropathy; your doctor may suggest eating smaller portions regularly rather than eating a large amount of food at one time. You may also be asked to limit the number of fats and fibres in your diet. For women with vaginal dryness, doctors may advise lubricants and for men with erectile dysfunction, doctors may prescribe medicines for the same.
How to Prevent Diabetic Neuropathy?
Controlling blood glucose levels is the best way to avoid diabetic neuropathy and to ensure this, you have to be consistent in the following:
- Monitoring blood glucose levels
- Taking medicines as prescribed
- Managing your diet
- Being active
In case you are diagnosed with diabetic neuropathy, make sure you consult your doctor and follow all the recommendations given by them to ensure a reduced progression of the condition. With effective and proper care, you can also reduce the risk of damaging the nerves and other complications.
