What is Diabetic Peripheral Neuropathy?

Statistics show that over 25 million people in the U.S. have diabetes. Diabetes, also called diabetes mellitus, is a group of metabolic diseases where the body has a high level of blood glucose (blood sugar). This disease can be caused from a lack of insulin production within the body or because cells in the body aren’t reacting properly to insulin.

There are two main types of diabetes, Type 1 and Type 2. Type 1 diabetes, also known as juvenile diabetes, usually affects people by the age of thirty, although it can be diagnosed at any age. Type 1 diabetes develops when the pancreas is not producing enough insulin within the body. This type of diabetes usually develops suddenly, with the person experiencing symptoms of high blood sugar such as increased urination, blurred vision, thirst, and weight loss. Type 2 diabetes, also called adult onset diabetes, occurs because the body doesn’t produce enough insulin or because cells do not react to insulin. About 90% of people with Type 2 diabetes are overweight. The symptoms are similar to Type 1 diabetes, but develop more gradually.

Diabetic peripheral neuropathy is one of the most frequent complications of diabetes. The condition affects about 50% of all diabetic patients. Diabetic peripheral neuropathy is nerve damage in the hands, arms, legs, and feet that is caused by diabetes. It is different than peripheral arterial disease (poor circulation) because the nerves are affected rather than the blood vessels.

Patients who develop diabetic peripheral neuropathy can remain asymptomatic for a long period of time. The condition most commonly develops gradually and becomes more severe over time. A patient’s sensory nerves, autonomic nerves, and motor nerves can all be affected with diabetic peripheral neuropathy. Symptoms include loss of sensation stemming from the toes up through the body into the arms and hands, which may worsen at night. Loss of sensation has been shown to make patients more prone to skin ulcers (open sores) and other complications.

 

Causes of  Diabetic Peripheral Neuropathy

When nerve fibers in the limbs are persistently exposed to high blood glucose levels they become damaged, resulting in diabetic peripheral neuropathy. Not only can high blood glucose levels affect the nerve’s ability to transmit signals, but it can damage blood vessel walls, which provide a source of oxygen to the nerves.
Other factors that may cause diabetic peripheral neuropathy are genetics, inflammation of the nerves due to an autoimmune response, and the prolonged use of tobacco and alcohol. Diabetic peripheral neuropathy is commonly found in patients who poorly manage their diabetes, but those who maintain excellent blood glucose levels are also susceptible to the condition.
Symptoms may vary for patients with diabetic peripheral neuropathy. Common symptoms reported are a numbing or tingling sensation in the toes, feet, legs, fingers, hands, and arms. Other patients may experience a severe onset of pain, whereas some never develop symptoms at all.

Longevity of diabetic peripheral neuropathy can cause complications that may result in skin ulcers and infections.

Treatment for Diabetic Peripheral Neuropathy

After a diagnosis of diabetic peripheral neuropathy has been determined, it is essential for the patient to understand their condition and the importance of self-care. Patients should be extensively monitored every four to six weeks to assess any treatments being administered and their progress. Studies have shown that regular foot examinations can significantly reduce the chances of skin ulcers and infection.
The most important type of treatment for diabetic peripheral neuropathy is stable glycemic control. If a patient has extreme fluctuations in blood glucose levels, it has been suggested that this could aggravate the nerves and cause more pain. Simple types of treatment are also recommended for mild types of pain, such as over-the-counter pain relievers, such as NSAIDS, and wearing loose clothing and suitable footwear with extra support.
Tricyclic drug treatments are another type of therapy often used to manage diabetic neuropathy. Studies have shown this treatment to have high success rates for pain management, but side effects can be problematic in certain patients.


Alternative treatments, such as acupucture
 and vitamin supplements have also been found to be beneficial for diabetic peripheral neuropathy patients. These treatments work well as a long-term pain relief therapy. Alternative treatments are also recommended to those patients who are seeking pain relief without the use of prescription medication.

More advanced treatment options are available to patients who experience severe pain from diabetic neuropathy, such as spinal cord stimulation.

Conclusion

Diabetic peripheral neuropathy is one of the most common problems derived from diabetes. Not only can it cause loss of sensation in the feet, legs, arms, and hands, but it can also produce chronic pain. There are many treatment options available for diabetic peripheral neuropathy. It is important that physicians consistently monitor and re-evaluate a patient’s treatment plan in order to track progress and eventually taper therapies when possible.

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