Overview of Diabetic Neuropathy
Over time, people with diabetes can sustain damage to nerves throughout the body. Diabetic neuropathies are a family of nerve disorders caused by diabetes. Neuropathies lead to numbness and sometimes pain and weakness in the hands, arms, feet, and legs. Problems may also occur in every organ system within the body.
People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater the risk. An estimated 50% of those with diabetes have some form of neuropathy, but not all with neuropathy have symptoms. The highest rates are among people who have had diabetes for at least 25 years. Diabetic neuropathy also appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40.
TYPES OF DIABETIC NEUROPATHIES
Diabetic neuropathies can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in different ways. In this article, we’ll review peripheral neuropathy.
Peripheral neuropathy is the most common type of diabetic neuropathy. Also called distal symmetric neuropathy, it causes either pain or loss of feeling in the toes, feet, legs, hands, and arms. The feet and legs are likely to be affected before the hands and arms.
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.
Many people with diabetes have signs of neuropathy upon examination, but have no symptoms. Symptoms are often worse at night and may include:
- Numbness or insensitivity to pain or temperature
- Tingling, burning, or prickling sensation
- Sharp pains or cramps
- Extreme sensitivity to touch, even a light touch
- Loss of balance and coordination
Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in gait (walking). Foot deformities, such as hammertoes and the collapse of the midfoot may occur.
Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. If foot injuries are not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated. Some experts estimate that half of all such amputations are preventable if minor problems are caught and treated in time.
Source: Prairie Spine and Pain Institute, Dr. Richard A. Kube II, MD.