Diabetic
neuropathy
(Nerve
damage
-
diabetes)
|
Definition
A
common
complication
of
diabetes
mellitus
in
which
nerves
are
damaged
as
a
result
of
hyperglycemia
(high
blood
sugar
levels).
Cause
People
with
diabetes
commonly
develop
temporary
or
permanent
damage
to
nerve
tissue.
Nerve
injuries
are
caused
by
decreased
blood
flow
and
high
blood-sugar
levels,
and
are
more
likely
to
develop
if
blood-glucose
levels
are
poorly
controlled.
Some
diabetics
will
not
develop
nerve
damage,
while
others
may
develop
this
condition
relatively
early.
On
average,
the
onset
of
symptoms
occurs
10
to
20
years
after
diabetes
has
been
diagnosed.
Approximately
50%
of
people
with
diabetes
will
eventually
develop
nerve
damage.
Peripheral
nerve
injuries
may
affect
cranial
nerves
or
nerves
from
the
spinal
column
and
their
branches.
This
type
of
neuropathy
(nerve
injury)
tends
to
develop
in
stages.
Early
on,
intermittent
pain
and
tingling
is
noted
in
the
extremities,
particularly
the
feet.
In
later
stages,
the
pain
is
more
intense
and
constant.
Finally,
a
painless
neuropathy
develops
when
pain
sensation
is
lost
to
an
area.
This
greatly
increases
the
risk
of
severe
tissue
injury
because
pain
no
longer
alerts
the
person
to
injury.
Autonomic
neuropathies
affect
the
nerves
that
regulate
involuntary
vital
functions,
including
the
heart
muscle,
smooth
muscles
and
glands.
Low
blood
pressure,
diarrhea,
constipation,
sexual
impotence,
and
other
symptoms
can
be
caused
by
autonomic
neuropathies.
Symptoms
-
Numbness
-
Tingling
-
Decreased
sensation
to
a
body
part
-
Loss
of
sensation
to
a
body
part
or
area
-
Diarrhea
-
Constipation
-
Loss
of
bladder
control
-
Impotence
-
Facial
drooping
-
Drooping
eyelid
-
Drooping
mouth
-
Vision
changes
-
Dizziness
-
Weakness
-
Swallowing
difficulty
-
Speech
impairment
-
Muscle
contractions
Note:
Symptoms
vary
depending
on
the
nerve(s)
affected
and
may
include
symptoms
other
than
those
listed.
Symptoms
usually
develop
gradually
over
years.
Signs
and
Tests
Physical
examination,
including
neurological
and
sensory
tests,
may
reveal
many
neuropathies.
A
common
early
finding
is
the
absence
of
ankle
reflexes.
Treatment
The
goals
of
treating
diabetic
neuropathy
are
to
prevent
progression
and
reduce
the
symptoms
of
the
disease.
Tight
control
of
glucose
is
important
to
prevent
progression.
To
reduce
the
symptoms,
topical
treatment
with
Capsaicin
or
oral
medication
like
amitriptyline,
gabapentin,
and
carbamazepine
have
been
used
successfully.
Analgesics
(pain
medications)
are
rarely
of
much
benefit
in
the
treatment
of
painful
neuropathy.
Regular
foot
exams
are
important
to
identify
small
infections
and
prevent
progression.
If
foot
injuries
go
unnoticed
for
too
long,
amputation
may
be
required
.Expectations
(prognosis)
The
mechanisms
of
diabetic
neuropathy
are
poorly
understood.
At
present,
treatment
alleviates
pain
and
can
control
some
associated
symptoms,
but
the
process
is
generally
progressive.
Complications
There
is
an
increased
risk
of
injury
to
the
feet
because
of
loss
of
sensation.
Small
infections
can
progress
to
ulceration
(skin
and
soft
tissue
breakdown)
and
require
amputation.
In
addition,
motor
nerve
damage
can
lead
to
muscle
breakdown
and
imbalance.
Prevention
It
is
clear
now
that
tight
control
of
blood
sugar
level
(Hemoglobin
A1C
<
7.0)
prevents
the
development
of
neuropathy
in
60%
of
type
1
diabetics
and
decreases
the
severity
of
symptoms.
In
addition,
regular
foot
care
can
prevent
a
small
infection
from
progressing.
Recommendation
Full
Length
dual
density
supports
Silicone
Full
Length
Inserts
Silicone
Gel
3/4
length
inserts
Casual
Support
Orthotics
w/
full
1/8"
Pad,
Suede
Cover
Casual
Orthotics
1/8"
Pad
&
Suede
Cover
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content
is
not
intended
to
be
a
substitute
for
professional
medical
advice,
diagnosis,
or
treatment.
Always
seek
the
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with
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regarding
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