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Diabetic Neuropathy

· Diabetes

Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes.
High blood sugar can injure nerves throughout your body. Diabetic neuropathy most
often damages nerves in your legs and feet.

Depending on the affected nerves, symptoms of diabetic neuropathy can range from
pain and numbness in your legs and feet to problems with your digestive system,
urinary tract, blood vessels and heart. Some people have mild symptoms but for
others diabetic neuropathy can be quite painful and disabling.

Symptoms

There are four main types of diabetic neuropathy. You can have one or more than
one type of neuropathy. Your symptoms will depend on the type you have and which
nerves are affected. Usually, symptoms develop gradually. You may not notice
anything wrong until considerable nerve damage has occurred.

  1. Peripheral neuropathy

Peripheral neuropathy is the most common type of diabetic neuropathy. It affects

the feet and legs first, followed by the hands and arms. Signs and symptoms of
peripheral neuropathy are often worse at night, and may include:

  • Numbness or reduced ability to feel pain or temperature changes
  • Tingling or burning sensation
  • Sharp pains or cramps
  • Increased sensitivity to touch — for some people, even the weight of a bedsheet
  • can be painful
  • Muscle weakness
  • Loss of reflexes, especially in the ankle
  • Loss of balance and coordination
  • Serious foot problems, such as ulcers, infections, and bone and joint pain

    2. Autonomous neuropathy

The autonomic nervous system controls your heart, bladder, stomach, intestines, sex
organs and eyes. Diabetes can affect nerves in any of these areas, possibly causing:

  • A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)
  • Bladder problems, including urinary tract infections or urinary retention or
  • incontinence
  • Constipation, uncontrolled diarrhea or both
  • Slow stomach emptying (gastroparesis), causing nausea, vomiting, bloating and
  • loss of appetite
  • Difficulty swallowing
  • Increased or decreased sweating
  • Problems controlling body temperature
  • Changes in the way your eyes adjust from light to dark
  • Increased heart rate at rest
  • Sharp drops in blood pressure after sitting or standing that may cause you to
  • faint or feel lightheaded
  • Erectile dysfunction
  • Vaginal dryness
  • Decreased sexual response
 

    3.Radiculoplexus neuropathy

Radiculoplexus neuropathy affects nerves in the thighs, hips, buttocks or legs. It's
more common in people with type 2 diabetes and older adults. Symptoms are
usually on one side of the body, but sometimes may spread to the other side. You
may have:

  • Severe pain in a hip and thigh or buttock that occurs in a day or more
  • Eventual weak and shrinking thigh muscles
  • Difficulty rising from a sitting position
  • Abdominal swelling, if the abdomen is affected
  • Weight loss

Most people improve at least partially over time, though symptoms may worsen
before they get better.

    4. Focal neuropathy

Focal neuropathy is damage to a specific nerve in the face, middle of the body or leg.
It's most common in older adults. Focal neuropathy often strikes suddenly and can
cause severe pain. However, it usually doesn't cause any long-term problems.
Symptoms usually go away without treatment over a few weeks or months. Your
specific signs and symptoms depend on which nerve is involved. You may have pain
in the:

  • Shin or foot
  • Lower back or pelvis
  • Front of thigh
  • Chest or abdomen
  • Focal neuropathy may also cause nerve problems in the eyes and face, leading to:
  • Difficulty focusing
  • Double vision
  • Aching behind one eye
  • Paralysis on one side of your face

Contact your doctor if you have:

  • A cut or sore on your foot that is infected or won't heal
  • Burning, tingling, weakness or pain in your hands or feet that interferes with
  • daily activities or sleep
  • Changes in digestion, urination or sexual function
  • Dizziness

These signs and symptoms don't always mean you have nerve damage. But they can
be a sign of another condition that requires medical care. Early diagnosis and
treatment of any health condition gives you the best chance for controlling your
diabetes and preventing future problems.

Causes

The exact cause likely differs for each type of neuropathy.

  • Inflammation in the nerves caused by an autoimmune response. The immune system mistakes nerves as foreign and attacks them.
  • Genetic factors unrelated to diabetes may make some people more likely to develop nerve damage.
  • Smoking and alcohol abuse damage both nerves and blood vessels and significantly increase the risk of infection.

Risk factors

Anyone who has diabetes can develop neuropathy but these risk factors make you
more likely to get nerve damage:

  • Poor blood sugar control: Uncontrolled blood sugar puts you at risk of every diabetes complication, including nerve damage.
  • Diabetes history: Your risk of diabetic neuropathy increases the longer you have diabetes, especially if your blood sugar isn't well-controlled.
  • Kidney disease: Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nerve damage.
  • Being overweight: Having a body mass index (BMI) greater than 24 may increase your risk of diabetic neuropathy.
  • Smoking: Smoking narrows and hardens your arteries, reducing blood flow to your legs and feet. This makes it more difficult for wounds to heal and damages the peripheral nerves.

Complications

Diabetic neuropathy can cause a number of serious complications such as:

  • Loss of a toe, foot or leg
  • Joint damage
  • Urinary tract infections and urinary incontinence
  • Hypoglycemia unawareness
  • Sharp drops in blood pressure
  • Digestive problems
  • Sexual dysfunction
  • Increased or decreased sweating

Prevention

You can prevent or delay diabetic neuropathy and its complications by keeping tight
control of your blood sugar and taking good care of your feet.

Blood sugar control: Use an at-home blood sugar monitor to check your blood sugar
and make sure it consistently stays within target range. It's important to do this on
schedule. Shifts in blood sugar levels can accelerate nerve damage.

To protect the health of your feet: Check your feet every day. Look for blisters, cuts,
bruises, cracked and peeling skin, redness, and swelling. Use a mirror or ask a friend
or family member to help examine parts of your feet that are hard to see.

Diagnosis

A doctor can usually diagnose diabetic neuropathy by performing a physical exam
and carefully reviewing your symptoms and medical history.

Your doctor will check your:

  • Overall muscle strength and tone
  • Tendon reflexes
  • Sensitivity to touch and vibration

Along with the physical exam, your doctor may perform or order specific tests to help diagnose diabetic neuropathy, such as:

  • Filament test: your doctor will brush a soft nylon fiber over areas of your skin to test your sensitivity to touch.
  • Quantitative sensory testing: this noninvasive test is used to tell how your nerves respond to vibration and changes in temperature.
  • Nerve conduction studies: this test measures how quickly the nerves in your arms and legs conduct electrical signals. It's often used to diagnose carpal tunnel syndrome.
  • Electromyography: often performed along with nerve conduction studies, EMG measures the electrical discharges produced in your muscles.
  • Autonomic testing: if you have symptoms of autonomic neuropathy, special tests may be done to determine how your blood pressure changes while you are in different positions, and whether you sweat normally.

Treatment

Diabetic neuropathy has no known cure. The goals of treatment are to:
Slow progression of the disease
Relieve pain
Manage complications and restore function

Finding diabetic neuropathy at an early stage is the best way to control it. Do not
forgot that working out and maintaining a healthy blood sugar level are two ways
that aid preventing diabetic neuropathy. The Spike App can help you maintain your
blood sugar level by reminding you to take your insulin injections multiple times a
day! Also, do not forget to subscribe to our YouTube Channel ( https://www.youtube.com/channel/UCw5ohw_YgzMYXqbZscQUXlw ) to stay up to date!

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