Overview, Causes, & Risk Factors
Diabetic neuropathy is an injury to the nervous system caused byunderlying diabetes mellitus.
What is going on in the body?
Diabetes mellitus, oftencalled diabetes, is a condition that affects the body’s ability to regulate thelevel of glucose in the blood. Glucose is the main form of sugar in the body.It is suspected that high blood glucose levels are neurotoxic. This is another way of saying that they have apoisonous effect on the nerves. If blood glucose levels are elevatedsignificantly for a period of time, the nerves can be permanentlydamaged.
What are the causes and risks of the disease?
Diabetic neuropathy is a complication of high blood glucose in people who havediabetes.
Symptoms & Signs
What are the signs and symptoms of the disease?
Some evidence of neuropathy is present in60% of all individuals with diabetes. Thirty percent to 40% of thoseindividuals have not yet developed symptoms. When symptoms do occur, they mayinclude any or all of the following:
Diagnosis & Tests
How is the disease diagnosed?
The diagnosis of diabetic neuropathy begins with a medical history and physical exam.The healthcare provider may order tests such as the following:
Prevention & Expectations
What can be done to prevent the disease?
A 10-year study by the National Institute of Diabetes and Digestive and KidneyDiseases showed that blood glucose control is key in preventing diabeticneuropathy. People who kept their blood glucose levels as close to the normalrange as possible were able to delay the onset and progression of neuropathy.
Diabetic neuropathy is also more common in people who are more than 40 years old. It is more likely in those who smoke. Heredity also plays a role, since some people aremore susceptible to nerve damage than others.
What are the long-term effects of the disease?
If diabetic neuropathy is not treated effectively, it can have devastatingeffects. Muscles may waste and become weak. Sensory involvement may produceprogressive numbness and pain. In extreme cases, sensoryinvolvement can lead to diabeticulcers and amputation.
What are the risks to others?
Diabetic neuropathy is not contagious, and poses no risk to others.
Treatment & Monitoring
What are the treatments for the disease?
Good control of blood glucose levels prevents further nerve damage. Low glucose levels can reverse the pain or numbness from nervedamage.
Treatment for pain caused by diabetic neuropathy includes the following therapies:
The following medications may be used for treatment of pain caused by diabetic neuropathy:
Gastroparesis may betreated by taking the following steps:
Medications that can be used in the treatment of gastroparesis are as follows:
Diarrhea and otherintestinal problems may be treated with the following:
Antibiotics are used to treat urinary tract infections. The affected person may betaught to empty the bladder frequently. He or she may be advised to increasefluid intake.
Men who have erectile dysfunctionmay be treated with medication. Sometimes a penile implant is recommended. Counseling may be helpful to reducestress.
What are the side effects of the treatments?
Antibiotics and other medications may cause stomach upset or allergic reactions.
What happens after treatment for the disease?
Good control of blood glucose levels is important. It can help prevent the onset and progressionof neuropathy. Once sensation is impaired to an area, the person will need tobe careful to avoid injury. Good diabetic foot care, for example, is especially importantif the feet are numb.
How is the disease monitored?
The individual and his or her healthcare provider can monitor diabeticneuropathy. Repeat electromyography and nerve conduction velocity studies may be helpful. Any new orworsening symptoms should be reported to the healthcare provider.
Article type: xmedgeneral