Diabetic neuropathy results from the nerve damage due to the high blood sugar levels of diabetic patients. It affects the nerves throughout the body with the nerves of the legs and feet as the most common targets. Symptoms of this complication depend on the location of the affected nerves.
When the nerve fibers are constantly exposed to high blood sugar, damages occur causing neuropathy. This interferes with the transmission of signals between nerves. The walls of the capillaries are weakened causing problems in the supply of oxygen and nutrients to the nerves. Inflammation due to autoimmune attack can also cause nerve damage. Smoking and alcohol abuse also damage the nerves and blood vessels.
Types of Diabetic Neuropathy:
· Peripheral neuropathy is the most common type of diabetic neuropathy. It often starts on the feet and legs followed by the hands and arms. Its symptoms typically worsen at night.
- Autonomic neuropathy affects the nerves of the heart, bladder, lungs, stomach, intestines, sex organs or eyes.
- Proximal neuropathy or diabetic amyotrophy affects the nerves of the thighs, hips, buttocks, and legs. This type commonly occurs in patients with Type 2 diabetes and older patients. Most of the symptoms occur on one side of the body.
- Mononeuropathy or focal neuropathy occurs suddenly and affects a specific nerve. It causes severe pain but rarely leads to long-term problems. Its signs and symptoms resolve within a few weeks or months even without treatment. It can also occur when a nerve is compressed or constricted like in carpal tunnel syndrome.
Diagnosis of diabetic neuropathy is based on the patient’s symptoms, a physical exam and medical history especially the control of his/her blood sugar level. Sensitivity to touch can be assessed using a monofilament. Nerve conduction tests are used to measure the speed of the arms and legs in conducting electrical signals while electromyography measures the electrical discharges of the muscles.
Commonly Prescribed Drugs
- Anti-seizure medications are given to manage nerve pain. Anti-seizures prescribed for diabetic neuropathy include gabapentin, pregabalin, and carbamazepine. Side effects: drowsiness, dizziness, swelling
- Antidepressants manage the chemical processes in the brain to alleviate the pain. Examples of antidepressants for nerve pain include amitriptyline, desipramine, and imipramine. Side effects: dry mouth, sweating, weight gain, constipation, dizziness