Diabetic neuropathy

Specialty of Pain medicine

What is it?

Diabetic neuropathy is the result of the action of diabetes on nerve cells in your body. It involves an increasing loss of sensitivity together with physical fatigue. This is due to the condition affecting multiple nerves at the same time, starting from the feet up towards the legs, hands and arms. This nerve-damaging disorder usually spreads symmetrically and evenly on both sides of the body.

What are the symptoms?

The signs of diabetic neuropathy emerge progressively, affecting the lower limbs first with a tingling sensation and soreness. The condition then starts to affect the hands and arms. Other symptoms may include an intense burning sensation, cramps and piercing pain which may happen during the night as well. In the most severe cases, you may suffer from either slow or rapid gastric emptying and from orthostatic hypotension, which in turn may result in poor balance and heart conditions. One of the most dangerous consequences of diabetic neuropathy is a lack of awareness for signs that blood sugar levels are low due to an adrenaline regulation mechanism disorder.

How is it diagnosed?

Diabetic neuropathy is most commonly diagnosed with sensory examination:

  • touch (touching a thin thread and being able to feel it);
  • pain (feeling a pinch);
  • temperature (being able to detect a cold or warm feeling);
  • vibration (by using a tuning fork);
  • position (by moving the toes).

If the results are not clear after a clinical examination, you may also undergo an electroneurography examination in order to test the nerves’ connection status.

What causes diabetic neuropathy?

Diabetic neuropathy is a complication of diabetes, so a healthy lifestyle is essential not only to prevent diabetes but also to prevent its complications.

What is the treatment?

Unfortunately, there is no known way to reverse damage that has occurred to the nerves.

However, there are a range of treatments for diabetes which can help prevent complications arising. Insulin-based anti-diabetic therapy helps in bringing blood glucose levels back to a healthy level. Taking tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs) and capsaicin gels and patches may also be beneficial. Vitamin B supplements may be helpful as well.

Which doctor should I talk to?

It is important to see your existing diabetes specialist if you notice any signs of nerve damage, so that they can help you take control of your blood glucose levels.

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