Sustained high levels of blood sugar can damage blood vessels nourishing the nerves. The 4 types of diabetic neuropathies – peripheral, autonomic, proximal, and focal – affect specific body systems and have their individual causes and symptoms. Tingling in the feet, slow reflexes, low libido, paralysis on one side of the face, impaired vision, and dizziness are some symptoms of diabetic neuropathy.
Neuropathy is a complication that causes damage to the nerves. The nerve damage can be due to a combination of factors such as long duration diabetes, inflammation in nerves or injury, smoking, or alcohol use.
In diabetic neuropathy, high blood glucose levels for a prolonged period cause damage to small blood vessels that carry oxygen and essential nutrients to the nerves. The different groups of nerves affected by diabetic neuropathy are sensory, motor, and autonomic nerves. Based on the region that diabetic neuropathy affects, it is also classified as peripheral, autonomic, proximal, and focal. About 60% to 70% of people with diabetes have one or the other form of neuropathy.1
What To Look Out For
Based on the region of the body that diabetic neuropathy affects, it is classified into four types. Each type has its own symptoms, causes, and sometimes specific treatments too.
Symptoms can range from common discomforts such as indigestion and weakness to graver signs such as chest pain and Bell’s palsy.
It is the most common type of diabetic neuropathy. It is the nerve damage in the legs and hands. Common symptoms include extreme sensitivity to touch, sharp pains or cramps, loss of balance, numbness or tingling sensation of the feet, muscle weakness, burning sensation in the feet, and loss of reflexes, especially in the ankle.
It affects nerves that control involuntary functions. This has repercussions on internal organs, causing problems with blood pressure, urination, sexual response, and digestion. Increased heart rate when at rest, dizziness, constipation or diarrhea, or a combination of both, increased or decreased sweating, incontinence or inability to empty the bladder fully, low libido, erectile dysfunction are manifestations of this form of neuropathy.
Proximal Neuropathy Or Diabetic Amyotrophy
It affects nerves in the thighs, hips, legs, or buttocks. A very debilitating condition, it is more common in people with type 2 diabetes and in older people with diabetes. The symptoms are usually on one side of the body. Sudden pain in the hip and thigh, abdominal swelling, weight loss, and weak thigh muscles mark this condition. Abrupt and acute pain, often sharp or burning, in the leg and around the hip and knee muscles is a common characteristic. Since it gradually subsides, the pain is often not taken seriously or misdiagnosed. Depending on the nerve damage, the length of recovery varies.2
It affects nerves in the head, torso, or leg. It may cause double vision, inability to focus the eye, pain in the pelvis or lower back, chest or abdominal pain, pain in the front thigh, and even Bell’s palsy, a paralysis on one side of the face.
Diagnosis: Hit And Miss?
Because diabetic neuropathy involves a plethora of symptoms, the possibilities of misdiagnosis are high. For example, diabetic peripheral neuropathy may be mistaken for osteoarthritis or even Morton’s neuroma, a painful foot condition that affects the nerves in the foot.3 Other symptoms of diabetic neuropathy such as weakness, slow reflexes, or pain in the lower back may be attributed to the aging process. This often stops the patient from seeking medical help and therefore complicates the condition.
Connecting individual episodes of discomfort like indigestion, weakness, or back pain to diabetic neuropathy is often difficult and challenging. That is why a rigorous study of the patient’s symptoms and history, and a physical examination are important to diagnose the condition. The physician will use this information to decide the nerve groups that are affected and classify the disorder into any of the four diabetic neuropathies. An electrodiagnostic assessment can further identify the location of the nerve damage. A biopsy may also help the physician confirm the diagnosis.
References [ + ]
|1.||↑||Diabetic Neuropathies: The Nerve Damage of Diabetes, The National Institute of Diabetes and Digestive and Kidney Diseases, USA.|
|2.||↑||Laino, Charlene. “Diabetic proximal neuropathy: getting at the root of the problem: new insights into diagnosis and treatment.” Neurology Today 4, no. 2 (2004): 52-53.|
|3.||↑||Aaron I. Vinik, “Towards an Understanding of Pain in Diabetic Neuropathy.” Medscape Diabetes & Endocrinology.|