Diabetic peripheral neuropathy is one of the many potential complications of diabetes. This condition can be painful and, in some cases, even dangerous. To understand why diabetic peripheral neuropathy occurs, it’s first necessary to understand what diabetes is.
Diabetes is a metabolic disease that keeps the body from processing foods properly.
Foods become a type of sugar in the blood stream, called glucose. The pancreas releases a hormone called insulin that helps cells use glucose as energy. However, people with diabetes can’t process this sugar properly and end up with very high levels of blood glucose.
This could be because the pancreas cannot produce any or enough insulin, as in type 1 diabetes. Alternately, in type 2 diabetes, either the pancreas can no longer produce enough insulin or the body’s cells become resistant to insulin. Uncontrolled diabetes leads to dangerously high levels of sugar in the blood. These high sugar levels can lead to heart disease, eye damage, kidney damage, and more.
The elevated blood sugar levels that characterize uncontrolled diabetes can also cause nerve damage, also called neuropathy.
When nerve fibers in the limbs are exposed to the high blood sugar levels that characterize diabetes, transmissions along the nerves can be affected. Additionally, the blood vessels that oxygenate the nerves can be injured, depriving the nerves of nourishment and damaging them further. Several other factors can increase the risk of developing diabetic neuropathy, such as:
- Genetic factors
- Inflammation of the nerves due to autoimmune conditions
- Tobacco use
- Alcohol use
However, the biggest risk factor for diabetic peripheral neuropathy is uncontrolled blood sugar levels. This means that the best way to prevent the development of diabetic peripheral neuropathy is to stay active, monitor blood sugar levels, take any medications prescribed by physicians, and make careful food choices, especially about sugary or starchy foods.
Multiple types of neuropathy are possible with diabetes. Autonomic neuropathy affects the autonomic processes, such as digestion, bowel and bladder function, perspiration, and sexual response. Additionally, autonomic neuropathy can affect the heart, blood pressure, lungs, eyes, as well as cause hypoglycemic unawareness.
Proximal neuropathy can cause pain in the buttocks, thighs, and hips, eventually leading to weakness in the legs. Focal neuropathy causes sudden weakness or pain of one particular nerve or group of nerves and can occur anywhere in the body.
The most common type of diabetic neuropathy is peripheral.
It’s estimated that more than half of all diabetics eventually develop peripheral neuropathy. The risk of diabetic neuropathy, including diabetic peripheral neuropathy, increases with both age and the duration of the disease. People who have had diabetes for 25 years or more experience the highest rate of diabetic neuropathy.
This type of neuropathy affects the peripheral extremities, including the toes, feet, legs, fingers, hands, and arms. Symptoms can vary from person to person, as well as change over time. Tingling, prickling, pinching, cold, or buzzing feelings are all possible. Other people might feel sharp pain, stabbing pain, cramps, or a burning sensation. Muscle weakness or balance problems can also occur, which can make walking difficult. Numbness or loss of sensation is also possible.
Sometimes there may be no symptoms at all of diabetic peripheral neuropathy. It may begin with just one or two symptoms and progress to more. In some cases, there may never be any symptoms.
There are several treatment options when diabetic peripheral neuropathy causes pain.
Careful control of blood sugar levels is the best way to treat diabetic peripheral neuropathy. It is still possible to experience symptoms of diabetic peripheral neuropathy while controlling blood sugars carefully, however. If this is the case, over-the-counter pain medications or vitamin supplements might be enough to alleviate pain. Tricyclic antidepressants prescribed by a physician could also help.
For individuals who want to avoid medications, acupuncture might relieve discomfort. Traditional acupuncture involves the insertion of thin, sterile needles into strategic points on the body. Acupuncture may relieve pain because needle insertion stimulates the release of pain-relieving endorphins. It may also be a good way to treat pain from diabetic peripheral neuropathy because it can enhance nerve conduction.
In extreme cases, therapies like spinal cord stimulation (SCS) can be used. SCS is the implantation of small leads into the spin. Electrical currents are delivered to interrupt pain signals along the spinal cord.
Loss of sensation in the extremities can lead to serious health risks.
A small cut or ulceration on the foot is usually no cause for concern, but if the foot is numb, the individual may be unaware that any injury has occurred. He or she may also be unaware if or when infection sets in. Infections can progress dangerously before they’re noticed. In some severe cases, this can lead to amputation. This is why it’s important that diabetics check their feet regularly for injuries.
Peripheral arterial disease (PAD) also commonly accompanies diabetes. This disease is characterized by atherosclerosis, or plaque build-up, on the walls of peripheral arteries. Plaque can form blockages that reduce blood flow along the arteries, causing poor circulation.
If an individual with diabetic peripheral neuropathy also suffers from PAD, it’s even more vital that the extremities are checked often for injuries. Poor circulation from PAD significantly slows healing and raises the risk of serious infection. A small cut from a stubbed toe or an ulcer from a poorly-fitting shoe can become badly infected very quickly.
Have you experienced pain from diabetic peripheral neuropathy?
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