What is Diabetic Neuropathy?

Diabetes-related neuropathy happens when your nerves get damaged because of high blood sugar that stays high for a long time. It can affect people who have had diabetes for a long time, like Type 1 and Type 2 diabetes. But not everyone with diabetes gets it.

Neuropathy can also happen because of other reasons, like pinched nerves, swelling, lack of certain nutrients, or injuries that hurt your nerves. Doctors say neuropathy is diabetes-related if you have diabetes and they don’t find any other cause.

What causes diabetic neuropathy?

Although the specific causes of diabetic neuropathy are unknown but various factors, such as:

• High blood sugar (glucose): High blood glucose levels alter chemical changes in nerves, impairing their ability to carry messages. It can also harm blood arteries, which transport oxygen and nutrients to the nerves.
• Metabolic factors: Apart from glucose levels, high triglyceride and cholesterol levels are also associated with an increased risk of neuropathy. Patients who are overweight or obese have a higher chance of acquiring neuropathy.
• Inherited factors: Some hereditary features may predispose some persons to nerve illness more than others.

What are the symptoms of diabetes-related neuropathy?

Your symptoms will depend on which type of diabetes-related neuropathy you have.

Symptoms of diabetes-related peripheral neuropathy

Diabetes-related peripheral neuropathy commonly affects your feet. Symptoms include:

• Numbness, tingling and/or pins and needles sensations (paresthesia).
• Pain, which may be burning, stabbing or shooting.
• Unusual touch-based sensations (dysesthesia).
• Muscle weakness.
• Slow-healing leg or foot sores (ulcers).

Total loss of sensation in your feet, like not feeling pain from foot injuries.

Peripheral neuropathy caused by nerve damage usually takes years to develop. You might not feel symptoms of mild nerve damage for many years.

Symptoms of diabetes-related autonomic neuropathy

Autonomic neuropathy can cause many different symptoms because it can impact many different body systems. Examples include:

• Digestive system: Indigestion, heartburn, nausea and vomiting, gas, diarrhea and constipation. Gastroparesis is a type of digestive system neuropathy.
• Urinary system: Urinary incontinence, urinary retention and frequent UTIs.
• Sex organs: Sexual impotence, inability to erection, retrograde ejaculation, vaginal dryness and anorgasmia.
• Cardiovascular system: Low blood pressure, irregular heart rate, dizziness and fainting.
• Sweat glands: Hyperhidrosis or hyposudorosis.
• Eyes: Difficult for your pupils to adjust to changes in light.

Diabetic autonomic neuropathy may also cause hypoglycemia unawareness. This is when you don't experience the usual warning signs of low blood sugar, like shakiness, confusion and intense hunger.

Symptoms of diabetes-related proximal neuropathy

Symptoms of proximal neuropathy include:

• Sudden and severe pain in your hip, buttock or thigh.
• Weakness in your leg that makes it difficult to stand up.
• Loss of reflexes, like the knee-jerk reflex.
• Loss of muscle tissue (atrophy) in the affected area.
• Unexplained weight loss.

What are the types of diabetic neuropathy?

Diabetes-related neuropathy can damage different nerves throughout your body. Types of diabetes-related neuropathy include:

• Peripheral neuropathy: This is the most common type of neuropathy. "Peripheral" refers to any of the nerves outside of your spinal cord. It often affects your feet and legs and sometimes your hands.
• Autonomic neuropathy: This neuropathy occurs because of damage in the autonomic nerves, responsible for involuntary bodily functions. The autonomic nerves control your body's bladder, intestinal tract, blood pressure, heart, and sex organs. Another term to describe autonomic neuropathy is dysautonomia.
• Proximal neuropathy: Proximal neuropathy is the rarest neuropathy, found in the nerve of your hip, thigh or buttock, and it occurs on one side of the body.

What are the risk factors for diabetes-related neuropathy?

If you have diabetes, your risk of developing diabetes-related neuropathy increases with age and the longer you have had diabetes.

Research has shown that peripheral neuropathy affects at least 20% of people with Type 1 diabetes who have had diabetes for at least 20 years. It affects 15% to 50% of people with Type 2 diabetes who have had diabetes for at least 10 years.

You’re also more likely to develop neuropathy if you have diabetes along with:

• High blood pressure (hypertension).
• High body mass index (BMI).
• High cholesterol.
• Kidney disease.
• Alcohol use disorder.
• Smoking.

Studies show that genetics may also increase your risk of diabetes-related neuropathy.

How is diabetes-related neuropathy diagnosed?

First, a healthcare provider will ask detailed questions about your medical history and diabetes management. They'll ask about your symptoms and do a physical exam. Tests that help confirm a diabetes-related neuropathy diagnosis include:

• Diabetes Foot Examination: Your doctor will visually examine your feet for injuries or other problems. They will then touch various tools to your toes and feet to check whether you are numb or not. This study also helps diagnose peripheral neuropathy.
• NCS: NCS is the test done to check the velocity of electrical discharges sent by the peripheral nerves across various parts of the body. This test helps in diagnosing both peripheral and proximal neuropathies.
• Electromyography: The EMG determines the health status of your skeletal muscles and nerve supplying these. This helps with peripheral and proximal neuropathy.

The specific test used depends on which organ system is damaged. For example, an ultrasound may reveal that you're actually not fully urinating. If you suspect some problems with digestion, you would need tests to find out digestive issues such as gastric emptying scintigraphy (GES).

Autonomic neuropathy is harder to diagnose as more diseases present symptoms with this pathology. So diagnosis usually takes some more time for diabetic neuropathies.

What are the treatment options for diabetic neuropathies?

Two-stage treatment procedure: Using lifestyle modifications and occasionally medicines to establish maximal diabetic control and symptomatic control of the complications of diabetes.

Control Blood Glucose

Control of blood glucose can't reverse the damage done but can prevent nerve damage from being worse. The doctor will then give you some specific blood sugar goals. Control of these includes a healthy diet that is full of protein but low in carbohydrates. When eating carbohydrates, choose foods with high fiber content over chips and drinks.

Regular exercise can help maintain blood sugar levels by boosting insulin sensitivity, which means you'll require less insulin each day. Getting enough sleep is also key, since we tend to seek high-carb foods when we are weary.

Improving Other Risk Factors

Although getting blood glucose under control is important, it might not be enough. Other risk factors like high triglycerides or cholesterol need to be controlled, and high blood pressure needs to be treated and smoking quit. Daily aerobic exercises have been shown to protect the nerves and improve neuropathy outcomes. Losing weight is also important if a patient is obese or overweight.

Managing Pain and Other Complications

Diabetic neuropathy can lead to chronic pain and complications like gastrointestinal problems, dizziness and weakness, and urinary or sexual problems. Various treatments are available, including the following:

• Pain medications.
• Anti-seizure medications.
• Antidepressants.
• Topical creams.
• Transcutaneous electronic nerve stimulation (TENS) therapy.
• Hypnosis.
• Relaxation training.
• Biofeedback training.
• Acupuncture.

Treatment will depend on your symptoms and the severity of your neuropathy.

You must check your toes daily for any problems such as ingrown toenails, blisters and sores. If you have peripheral neuropathy, numbness associated with neuropathy could mean you do not feel the onset of these conditions. Keeping your feet clean and covered can protect them from other forms of injury and from complications like infections.

How can I prevent diabetes-related neuropathy?

You can reduce your risk of diabetes-related neuropathy by:

• Keeping your A1C below 7%.
• Keeping your blood pressure below 140/90 mmHg or at the goal your doctor established.
• Following a healthy eating and exercise plan.
• Maintaining a healthy weight.
• Limiting or avoiding alcohol.
• Limiting or quitting smoking.
• Getting an annual checkup and foot test from your doctor.

It's also important to have daily self-examinations of your feet look for blisters, wounds, or broken skin. This is a good opportunity to catch quick signs of neuropathy — and complications from neuropathy.

How is the outlook for someone who has diabetes-related neuropathy?

If you have diabetes-related neuropathy, it is determined with several factors depending on the person, such as:

• The Type of Neuropathy.
• Severe neuropathy.
• Age of the patient along with the whole health condition.
• Your doctor will be able to give you a better idea of what to expect.

If not treated properly, peripheral neuropathy can really affect your quality of life. This is why it's important to seek medical help as soon as you notice signs of it.

Autonomic neuropathy can be a serious condition since it deals with your body's vital functions. When those fail to function appropriately, the effect can be severely — sometimes fatally — consequential.

What are complications of diabetes-related neuropathy?

Possible complications of peripheral neuropathy include:

• Skin breakdown.
• Infection.
• Ulceration.
• Charcot foot.
• Mobility problems.
• Fall and bone fractures.
• Amputation.

Complications of autonomic neuropathy differ according to which body system is affected

What care should I undertake in case of diabetic neuropathy?

Reversal of damaged nerves is rather tough, which makes diabetes neuropathy impact a lot on one's daily activity. Apart from managing diabetes along with your medical care provider sensitively and going through treatment from the neuropathic condition, here are things you can also do to manage your self- care:

• Using a cane, walker, or other mobility-assisting device so you can be on the go much easier.
• Special shoes can protect your feet from injuries.
• Self-check and identify foot and leg wounds early. Call a wound clinic to help when you notice them — do not wait!
• Remove throw rugs and other tripping hazards in your home to reduce falls.
• Seek therapy from a psychologist or therapist if living with neuropathy is affecting your mental health.
• Educate loved ones about neuropathy and what they can do to assist you.
• Join a support group to relate to others going through similar experiences.

When should I see my doctor if I have diabetes-related neuropathy?

People suffering from diabetes-related neuropathy may need to attend their doctor regularly so monitoring of symptoms in order to detect whether they're worsening or getting better can take place. For diabetes management adjustment, you are also required to visit your diabetes provider, commonly an endocrinologist, and make regular consultations.

Why choose Tender Palm Super-Speciality Hospital for Diabetic Neuropathy Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Diabetes-Related Neuropathy treatment in Lucknow, India, at an affordable cost. We have a team of experienced neurologists who provide accurate diagnosis and both non-pharmacological and pharmacological treatment options including blood sugar management, nerve pain control, and physiotherapy-based rehabilitation procedures. Our Neurology and Endocrinology team has decades of experience in successfully treating Diabetes-Related Neuropathy in Lucknow, India.

 To seek an Expert Consult for Diabetic Neuropathy Treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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