Causes of Diabetic Neuropathy
The causes of neuropathy in diabetic patients are unknown, but it is postulated that the nerve damage is caused by:
- Uncontrolled Hyperglycemia: High blood glucose damages the blood vessels that supply nerves in the body. The damage to blood vessels prevents essential nutrients and oxygen from reaching the nerves, resulting in eventual damage to the nerve fibers. The damage to the nerve fibers results in interference of signal transmission, which results in neuropathy.
Symptoms of Diabetic Neuropathy
Symptoms depend on the type of diabetic neuropathy you have. Diabetic neuropathy can be divided into four main types: Peripheral neuropathy, Autonomic neuropathy, Proximal neuropathy, and Mononeuropathy.
With all four types of neuropathy, symptoms typically develop slowly and can go unnoticed until there is severe nerve damage.
Diagnosis of Diabetic Neuropathy
Diagnosing diabetic neuropathy early is essential to the effective treatment of the condition, however, the tell-tale symptoms of diabetic neuropathy such as foot and limb pain do not immediately indicate diabetic neuropathy. Therefore, it is essential to have an accurate diagnosis to ensure that the patient receives proper treatment.
Diagnosis can typically be made through a physical exam where the physician tests for muscle strength and tone, reflexes, responses to stimuli, and sensitivity to vibration, temperature, pain, and touch.
In some cases, other methods will be used for diagnosis such as:
- Nerve biopsy: Removal and examination of a piece of a nerve allows for the identification of neuropathy.
- Electromyography (EMG): Checks how muscles respond to electrical impulses and is typically helpful in identifying peripheral neuropathy.
- Electrocardiogram (ECG): Checks for changes in the heart’s rhythm, which can help identify autonomic neuropathy.
- Nerve Conduction Studies: Measures how fast an electrical impulse travels through a nerve, which helps identify the presence of nerve damage.
- Ultrasound: Helps identify issues within the bladder, which is a common symptom of autonomic neuropathy.
- X-ray: Can show damage to nerves within the digestive system.
Treatment of Diabetic Neuropathy
There is not an existing cure for diabetic neuropathy, but there are methods to prevent the exacerbation of existing symptoms of the condition. Treatment options include:
- Maintaining a healthy blood sugar: Keeping blood sugar within target range recommended by your primary care physician. This target rage differs per individual so make sure to ask your primary care physician.
- Pain relief: There are a variety of pain relief medications that can address the pain associated with neuropathy including both over-the-counter and prescription options.
- Non-steroidal Anti Inflammatory Drugs (NSAIDs): These can help reduce inflammation and pain, and those available without prescription include aspirin, ibuprofen, and naproxen. These medications can interact with other drugs or cause sever side effects so it is important to consult a physician before taking them.
- Antidepressants: Certain antidepressants can help address the pain associated with neuropathy. The current antidepressant that is recommended by the FDA for the treatment of pain caused by neuropathy is Duloxetine (brand name is cymbalta or irenka)
- Hand or foot brace: Can help relieve muscle pain or muscle weakness
