Diabetes management is crucial to your longevity and health. When blood sugar levels are too high or too low, it can result in a series of complications. While there are always immediate risks in these fluctuations for people living with diabetes, long-term complications are just as serious. One serious long-term complication is diabetic neuropathy. In this article, we’ll cover everything you need to know about diabetic neuropathy so you can take the proper precautions to stay healthy and avoid problems.
What is Diabetic Neuropathy?
Diabetic neuropathy is a complication of poor management of both type 1 and type 2 diabetes. It occurs when there are consistent high blood sugar levels that your body is unable to regulate, resulting in nerve damage that can spread if not treated. Diabetic neuropathy is usually a disease that occurs slowly over time and worsens if blood sugar levels are not stabilized. It affects approximately 50% of people with type 2 diabetes and 20% of people with type 1 diabetes.
Causes of Diabetic Neuropathy
The cause of diabetic neuropathy is heightened blood sugar levels sustained over time. This is usually the result of poor diabetes management or the lack of knowledge that you have diabetes to begin with. There are two different types of nerves that diabetic neuropathy can affect—the small nerves that help protect your body from pain or extreme temperature changes and the large nerves that help detect touch and pressure.
Risk Factors of Diabetic Neuropathy
In addition to prolonged levels of high blood sugar, certain people are more at risk for diabetic neuropathy. If you have one or more of the risk factors, talk to your doctor about what you can do to take extra precautions against nerve damage. Similarly, make sure that you’re very diligent with your diabetes management to avoid any complications. Risk factors for diabetic neuropathy include:
- Poor control of diabetes
- High blood glucose levels
- Increasing age
- Duration of diabetes
- High blood pressure
- High cholesterol levels
- Obesity
- Smoking
- Improper foot care in diabetes
- Excess friction and/or pressure on feet
- Peripheral artery disease
- Excess drinking
- Kidney disease
Different Types of Diabetic Neuropathy
While diabetic neuropathy is associated with nerve damage, there are multiple areas throughout the body that this damage can occur. The four different types of diabetic neuropathy include peripheral neuropathy, autonomic neuropathy, proximal neuropathy, and focal neuropathy. The symptoms of diabetic neuropathy vary depending on the type that you have, so make sure to keep an eye out for any of the symptoms discussed below.
Peripheral Neuropathy
Peripheral neuropathy is the most common type of diabetic neuropathy. It usually affects the lower extremities, such as the feet and legs, but can also affect your arms or hands. Many people experience mild symptoms at first that progress onto severe symptoms. Symptoms can also vary throughout the day, becoming more severe at night. Symptoms include:
- Gradual onset of numbness, prickling, or tingling in your feet or hands that can spread into legs and arms
- Burning sensation
- Sensitivity to touch that can become extreme over time
- Insensitivity to extreme temperatures
- Sharp pain
- Cramping
- Muscle weakness
- A loss of balance or coordination
If you have peripheral neuropathy, it’s extremely important to regularly inspect your legs, feet, arms, and hands for any sign of injury. When left unchecked, cuts or abrasions can become infected and in serious cases, result in amputation.
Autonomic Neuropathy
This is the second most common type of diabetic neuropathy. Autonomic neuropathy affects the autonomous nervous system including many organs and muscles. Autonomic neuropathy can affect your digestive system, sweat glands, sex organs, urinary tract system, cardiovascular system, or a combination of any. Symptoms will vary depending on which system is affected, but include the following:
- Constipation
- Diarrhea
- Feeling full after only eating small amounts
- Nausea after eating
- Loss of control of bowel movements
- Swallowing problems
- A swollen abdomen
- Vomiting
- Abnormal heart rate or rhythm
- Lightheadedness
- High blood pressure
- Shortness of breath
- Difficulty beginning to urinate
- Feeling of incomplete bladder emptying
- Urine leakage
- Sweating excessively
- Not sweating at all
- Heat intolerance
- Sexual problems of dysfunction
- Small pupil in one eye
- Weight loss without effort
You may experience any of these symptoms depending on where the nerve damage is, or you may experience a number of them at once. Make sure to talk to your doctor if you’re suffering from symptoms of autonomic neuropathy to avoid serious complications.
Proximal Neuropathy
Proximal neuropathy is rare and also known as diabetic amyotrophy. This from or neuropathy occurs more often in older adults with fairly well controlled type 2 diabetes. It presents itself with sudden and sometimes severe pain in the hips, buttocks, or thighs and causes extreme muscle weakness. Proximal neuropathy tends to only affect one side of the body and many people make a full recovery without the assistance of treatment.
Focal Neuropathy
This type of diabetic neuropathy is also known as mononeuropathy and occurs when there’s only damage to one specific nerve or group of nerve. This causes weakness in whatever area is affected accompanied by high bouts of pain. Mononeuropathy often goes away without treatment but can result in carpal tunnel syndrome. Symptoms of focal neuropathy include:
- Pain
- Numbness
- Tingling
- Inability to focus
- Double vision
- Aching behind eyes
- Bell’s palsy
- Pain in isolated areas
Diabetic neuropathy can be prevented, but you need to make sure that you’re managing your blood sugar levels extremely vigilantly. Always make sure that you regularly monitor your blood glucose levels, take any medications as prescribed by your doctor, eat diabetic friendly food, and get regular exercise. If you’re suffering from diabetic distress, get help immediately to reduce the likelihood of long-term effects.
Complications of Diabetic Neuropathy
In addition to the general sense of nerve damage associated with the different types of diabetic neuropathy, there is also the risk of developing a number of serious complications. This often occurs because of your lack of ability to feel pain, notice any issues, or undergo predictable wound healing. These complications include:
- Hypoglycemia Unawareness – you may not notice warning signs of blood sugar levels under 70mg/dL, such as shakiness, sweating, and a fast heartbeat.
- Loss of Lower Limb – minor cuts can turn into sores without realizing due to the loss of feeling in lower extremities. If these aren’t properly cared for, they can result in infection which can lead to amputation in severe cases.
- Urinary Tract Infections – if the nerves controlling your bladder are damaged, you may not be able to empty your bladder completely. This increases your susceptibility to infections like UTIs.
- Urinary Incontinence – similarly, nerve damage in the bladder can make it difficult to feel when you need to urinate or affect the muscles that are used to control the release of urine. This can lead to incontinence.
- Sharp Drops in Blood Pressure – nerve damage has the ability to affect how your body adjusts to blood pressure, which can lead to sharp drops if you stand up too quickly.
- Digestive Problems – nerve damage localized in the digestive tract can lead to gastroparesis or other digestive problems.
- Sexual Dysfunction – nerve damage that affects sex organs can reduce or eliminate the ability to perform or enjoy sex.
- Increased or Decreased Sweating – sweat glands are controlled by nerves, so damage can result in an inability of your body to control its temperature.
If you have any complications of diabetic neuropathy, talk to your doctor about how you can treat them and improve your overall quality of life.
Diagnosing Diabetic Neuropathy
If you have any symptoms of diabetic neuropathy, it’s important to schedule a visit with your doctor. Properly diagnosing neuropathy will ensure that you receive the right treatment and any potential complications are addressed before they get worse. At the visit, your doctor will review your symptoms, medical history, and perform a physical examination.
Your doctor will also check sensitivity to temperature and touch to determine the seriousness of the nerve damage. Your feet will be examined alongside reflexes, and any loss of sensation. While there are no cut and dry diagnostic test for neuropathy, your doctor will work with you to best understand what’s happening and how to minimize future pain.
Treatment Options for Diabetic Neuropathy
While there is no cure for diabetic neuropathy, treatment options can help reduce your pain and lower your chances for serious complications. When diagnosed with diabetic neuropathy, improved management and treatment can help to slow the progression of nerve damage. If you smoke, quit. If you live a sedentary life, get active. In addition to making healthy, diabetes friendly lifestyle choices your doctor will likely discuss your options for pain management, managing any complications, and improving your overall quality of life. To help ensure that you’re managing your diabetes as best as possible, talk to your doctor about continuous glucose monitors.
Byram Healthcare cares about our patients and wants to make sure that you’re living a life free of any complications. For more support with your diabetes management, sign up for Byram Healthcare’s Caring Touch At Home™ Program.
