What Is Diabetic Peripheral Neuropathy?
With 25 million affected individuals, diabetes, known medically as diabetes mellitus, affects nearly one out of every 12 people in the United States. Patients with diabetes suffer from high blood sugar levels as a result of poor insulin production or insulin insensitivity.
Insulin is a molecule produced by the pancreas and is responsible for removing excess glucose from the bloodstream.
The two types of diabetes are referred to as Type 1 and Type 2. Type 1 diabetes is usually diagnosed in patients below 30, hence the additional term “juvenile diabetes,” although it may be diagnosed at older ages in some cases. Type 1 diabetes is caused by a loss of insulin production associated with the depletion of insulin producing beta cells from the pancreas. This form of diabetes may occur suddenly, and is more common in individuals with an affected family member. Symptoms include weight loss, blurred vision, increased urination, and thirst.
Type 2 diabetes symptoms develop more gradually, but are similar to Type 1 diabetes symptoms. However, the causes of these two diseases vary. Type 2 diabetes is characterized by insulin sensitivity, wherein the body no longer responds to insulin production. Initially, this is compensated by overproduction of insulin, but consistent overproduction often leads to a loss of insulin production. Type 2 diabetes is sometimes referred to as adult-onset diabetes, although the ages of diagnosis overlap. Type 2 diabetes is highly associated with weight, with about 90% of Type 2 diabetes patients being overweight.
Must Watch Video – What is Diabetic Peripheral Neuropathy?
A frequent complication of diabetes is diabetic peripheral neuropathy, affecting nearly half of all diabetic patients. Diabetic peripheral neuropathy is nerve damage in the limbs and extremities resulting from diabetes. This is distinct from peripheral arterial disease, which directly affects blood vessels.
Diabetic peripheral neuropathy may remain undiagnosed for long periods of time in asymptomatic individuals. When symptoms present themselves, they typically progress gradually and increase in severity over time. Diabetic peripheral neuropathy affects several types of nerves, including sensory, motor, and autonomic. The associated symptoms may become worse at night, and are characterized by a loss of sensation that can make patients prone to skin ulcers, lesions, and other complications of the extremities.
Causes Of Diabetic Peripheral Neuropathy
The persistent exposure of peripheral nerves to chronic high glucose levels causes nerve damage and leads to diabetic peripheral neuropathy.
This directly affects the nerves, while the damage to blood vessels diminishes the supply of nutrients to the nerve cells, compounding the damage. Chronic inflammation caused by a variety of factors may also contribute to diabetic peripheral neuropathy.
These factors include inflammation due to an autoimmune response, heavy alcohol or tobacco use, and genetics. All diabetic patients can be susceptible to diabetic peripheral neuropathy, but maintaining proper health and tight control of their blood sugar levels can reduce risk.
Depending on the patient, symptoms for diabetic peripheral neuropathy may vary. Many patients report feeling a tingling sensation or numbness in their limbs and extremities, while some patients experience a sudden and severe onset of pain. Furthermore, some patients may remain asymptomatic for a long period of time as the disease progresses. Long-term diabetic peripheral neuropathy patients may also experience skin ulcers and infections.
Treatments For Diabetic Peripheral Neuropathy
Effective management of diabetic peripheral neuropathy involves regular monitoring by a physician and proper self-care of the patient at home. A physician should monitor treatments and progress of the patient every four to six weeks and make adjustments to treatments accordingly. Additionally, podiatric examinations can reduce the risk of skin ulcers and complications that may arise with the feet.
Central to the root of the disease, all treatments require effective control of the patient’s blood sugar. Glucose fluctuations may aggravate the affected nerves, leading to additional damage and pain. In order to manage the pain, there are several options available. For mild pain, relief may be found by wearing comfortable, loose-fitting clothing, finding suitable footwear that includes extra support, or utilizing over-the-counter pain medications.
Diabetic peripheral neuropathy may also be managed with tricyclic or anticonvulsant medications. These medications do have additional side effects, so they may not be the best choice for all diabetic peripheral neuropathy patients.
For patients seeking alternative treatments and pain management, acupuncture and vitamin supplements may be beneficial. These have been used as part of a pain management regimen as part of a long-term therapy, and these treatments are also useful for patients who are seeking treatment without medications.
In more extreme cases where these treatments are insufficient to manage severe pain associated with diabetic peripheral neuropathy, spinal cord stimulation or other options of nerve blocks, may be suggested by your doctor.
Diabetic peripheral neuropathy is a common problem among diabetic patients. The associated tingling and numbness in the limbs and extremities can lead to skin ulcers, while some patients may suffer from severe chronic pain. Maintaining control over blood sugar levels in conjunction with other treatments can be effective at managing diabetic peripheral neuropathy. Careful monitoring by a physician and treatment adjustments can help manage the pain while help from a podiatrist can help reduce and manage skin ulcers. Long-term care is possible with the help of physicians and effective self-care at home.
- Abusaisha BB, Constanzi JB, Boulton AJM: Acupuncture for the treatment of chronic painful diabetic neuropathy: a long-term study. Diabetes Res Clin Pract. 1998;39:115-121.
- Dyck PJ, Katz KM, Karnes JL, Litchy WJ, Klein R, Pach JM: The prevalence by staged severity of various types of diabetic neuropathy, retinopath