Diabetic neuropathy – causes, symptoms, diagnosis, treatment, complications

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Diabetic neuropathy is a complication of diabetes that affects the work of the nervous system. The first symptoms of neuropathy are tingling in the hands and feet, numbness and itching. There are different diabetic neuropathies: sensory, autonomic and focal.

Diabetic neuropathy – causes

The main cause of diabetic neuropathy is hyperglycemia – increased levels of glucose in the blood, which causes disturbances in the structure of nerve fibers and disturbances in their function of conducting nerve impulses. Other factors that increase the risk of developing the disease include:

1. smoking,
2. excessive alcohol consumption,
3. hyperlipidemia, i.e. abnormal values ​​of LDL cholesterol and triglycerides in the blood,
4. genetic predisposition.

Diabetic neuropathy – types

Diabetic polyneuropathy can involve different types of nerve fibers:

1. sensory, which allow us to feel when someone touches us, we feel pain when we step on something sharp, we feel that we have been poured with cold water or boiling water, we are able to determine where our hand is, where our leg is, and where our leg is standing on the ground;
2. motor functions that allow us to properly function muscles, that we have the strength to perform various activities, even the most basic ones, such as raising a hand, combing, getting out of bed, as well as reacting to a given stimulus, e.g. taking a hand away from an object which stings a lot;
3. autonomic, the proper functioning of which ensures the proper functioning of the heart, digestive tract and many other internal organs, thanks to which we have the right pressure, we can eat and digest the food we eat, we have properly moisturized skin, we do not sweat excessively, we have warm feet and hands and properly nourished tissues .

Diabetic neuropathy – symptoms

Diabetic neuropathy is a disease that may be asymptomatic at first. It is then said to be a latent form, which can only be diagnosed by performing special tests of nerve fiber function.

The progress of the disease is closely related to the degree of glycemic control, i.e. blood glucose levels. The more diabetes is controlled (the more effectively it is treated), the greater the chances of delaying the onset of the disease. The symptoms of the disease depend on the type of nerve fibers involved and their location. There are many clinical syndromes. Symptoms that may occur include:

1. sensory disturbances (e.g. when you do not feel the touch, pain, cold or warm, you cannot tell where someone has grabbed your hand, you do not feel that your leg is standing on the ground);
2. numbness, tingling, burning, burning;
3. pain (which can vary in nature depending on the type of fiber involved. This can be a burning, superficial, iron-like pain associated with allodynia, where any stimulus (e.g. touch) is felt as pain; it can also be deeply located pain , tearing, dull, in the bones of the feet, reminiscent of a toothache, sometimes crushing, reminiscent of a painful muscle spasm – mainly around the feet and shins, usually at night;
4. reduction of muscle strength, muscle atrophy (when there may be difficulties in getting out of bed, lifting the shopping net, when limb deformation may occur);
5. impairment of autonomic functions (which may be manifested, for example, by the fact that we have reduced sweating, dry and cool skin, cold feet, wounds are difficult to heal, ulcers appear, there is reduced tolerance to exercise, edema appears, myocardial infarction may be asymptomatic and characteristic chest pain, in women possible vaginal dryness, decreased libido, in men erectile dysfunction, not feeling the symptoms of hypoglycaemia).

Do you have worrying symptoms? Do not hesitate and consult your doctor. You can use the online visit option and receive advice and e-prescription without leaving your home.

Read more: Characteristics of pain in peripheral neuropathy

What are the consequences of diabetic neuropathy?

Diabetic neuropathy can lead to many serious conditions. For this reason, it is considered a chronic complication of diabetes associated with the greatest morbidity and mortality, and a frequent reason for treatment in the hospital. It can impair not only sensation and movement, but also the functioning of vital organs. Patients with autonomic neuropathy of the heart are at risk of a silent myocardial infarction, respiratory failure, i.e. serious conditions posing a direct threat to life.

Diabetic neuropathy is also a reason for lowering the quality of life of patients. It is the cause of the so-called diabetic foot syndrome, leading to gangrene and loss of a limb. It is worth noting that as much as 50-75% of non-traumatic limb amputations occur in the diabetic foot.

Diabetic neuropathy – diagnosis and treatment

The diagnosis of diabetic neuropathy is based on a well-collected medical history (in which the greatest emphasis is placed on the duration of diabetes and the method of its treatment), neurological examination and many additional tests, in which various types of sensation and fiber conductivity are examined in a simple, non-invasive way. nervous.

If autonomic neuropathy is suspected, more additional tests may be required, including laboratory diagnosis of diabetes by measuring glucose and analyzing the work of the kidneys.

Diabetic neuropathy – prevention

Diabetic neuropathy arises as a complication of diabetes. Therefore, the most important element of treatment and prevention of early onset of the disease is proper antidiabetic treatment and control of metabolic control of diabetes. An additional treatment problem is pain, which in this case may not want to be treated with the usual painkillers. In its treatment, antidepressants, anticonvulsants, lipoic acid are used. It is not uncommon for this pain to be referred to a pain clinic.

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