Neuropathies are a variety of ailments which arise when nerves of the peripheral nervous system – the nervous system aside from the brain and spinal cord – are damaged; this is most commonly referred to as peripheral neuropathy. Approximately 50% to 70% of the people who suffer with diabetes, in all probability will have some form of neuropathy. Most often it affects the motor nerves which control muscle movement and the sensory nerves which are responsible for our awareness of sensations such as coldness or pain. It first becomes apparent in the extremities but can manifest itself in the heart, blood vessels, bladder and intestines
Types of Diabetic Neuropathy
Diabetic Neuropathy is often classified into four distinct categories: peripheral, autonomic, proximal and focal. Since neuropathy can affect nerves throughout the body this classification is dependent on which part of the body is affected.
(a) Peripheral neuropathy is the most common type and causes loss of feeling or pain in the hands, arms, toes, feet and legs. It can also cause muscle weakness and foot deformities. Due to the loss of feeling, injuries can go unnoticed, resulting in infection(s) and additional complications.
(b) Autonomic neuropathy affects the nerves which support the heart and blood vessels, the urinary tract, the lungs and eyes, the sex organs, the sweat glands and the digestive system. Autonomic neuropathy can also be responsible for hypoglycemia unawareness whereby a person no longer experience the warning symptoms of low blood sugar levels.
(c) Proximal neuropathy affects the thighs, hips, or buttocks resulting in weakness of the legs. Due to weakness of the legs it becomes difficult to go from a sitting to standing position and assistance may be required. This affliction is more common among persons with Type 2 diabetes.
(d) Focal neuropathy affects one nerve or a group of nerves leading to muscle weakness or pain. It can affect the nerves which control the facial muscles, eyes, ears, chest, abdomen, pelvis and lower back, thighs, legs and feet. It is painful and unpredictable, existing mostly among older adults suffering with diabetes. It tends to improve by itself and does not cause long-term damage.
The symptoms are dependent on: the type of neuropathy contracted, the nerve(s) affected (autonomic, motor, sensory) and their location. It is not uncommon for many types of neuropathy to affect all three types of nerves. Some neuropathies may appear suddenly while others develop gradually.
(a) Autonomic Nerve Damage: Swollen abdomen, Blurred vision, Feeling full quickly, Nausea/ Vomiting after eating, Constipation, Diarrhoea, Weight loss, Dizziness/Fainting, Overflow and/or Urinary incontinence, Difficulty beginning to urinate, Abnormal perspiring, Sensitivity to heat, Impotence in men and Vaginal dryness in women.
(b) Motor Nerve Damage: Experiencing difficulty to move a part of the body (loss of balance and coordination), Lack of dexterity and muscle control, Cramps or Spasms, Loss of muscle tissue and difficulty swallowing or breathing.
(c) Sensory Nerve Damage: Nerve pain, Tingling or numbness, Burning sensations, Lack of coordination and a Lessening or absence of sensation to such an extent that nothing can be felt.
Prevention Is Better Than Cure
Presently there’s no cure for diabetic neuropathy. Treatments are focused on prevention of further damage to the nerves and relief of pain (to those already afflicted) and are often determined by the extent to which the ailment has progressed. Antidepressants (low doses), Analgesics and anticonvulsant drugs may be prescribed for relief of burning, tingling and pain. Pills, creams, special diets and therapies to stimulate the nerves and muscles are also employed. Non-medicinal therapies may include: meditation, yoga, acupuncture, chiropractic massages and cognitive therapy. All treatments depend on the type of nerve problem and symptom.
Good foot health is particularly important and special preventative steps should be taken to avoid degenerative progress of the disease:
(a) Avoid continuous pressure on the knees and elbows
(b) Do not walk barefooted
(c) Avoid getting your feet too hot or cold
(d) Wash your feet daily with lukewarm water and mild soap
(e) Dry your feet well and use non-medicated powders with shoes, socks and stockings
(f) Apply cream or lotion to keep foot, especially heels smooth.
(g) Daily foot exams, checking for cuts, blisters, calluses or bruises.
The best way of preventing diabetic neuropathy is by adhering to the recommended treatment for your diabetes as prescribed by your doctor. Taking your diabetes medicines or insulin, blood glucose monitoring, a proper diet and physical activity will help keep your blood sugar levels under control. Keeping your blood glucose level as close to normal as possible will help protect the nerves throughout the entire body.
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