Dr. Seema Gupta

Diabetic neuropathy is a nerve disorder caused by diabetes. The high blood sugar from diabetes affects the nerves and over time increases a person's risk for nerve damage. Keeping blood sugar levels within the target range recommended by your doctor helps prevent diabetic neuropathy.

Types of Diabetic Neuropathy-

1. Diabetic neuropathy can be classified as Peripheral, Autonomic, Proximal, or Focal. Each affects different parts of the body in various ways...
2. Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, and hands.
3. Autonomic neuropathy affects the nerves that control involuntary body functions such as digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.
4. Proximal neuropathy causes pain in the thighs, hips, arms, or buttocks and leads to weakness in the legs and hands, resulting in difficulty in walking, standing, picking up objects, buttoning your clothes, etc.
5. Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.

How Diabetes Causes Damage to the Nervous System?
There are several factors that are likely to contribute to nerve damage through diabetes...

1. High blood glucose, a condition associated with diabetes, causes chemical changes in nerves. These changes impair the nerves' ability to transmit signals. 
2. High glucose levels affect many metabolic pathways in the nerves, leading to an accumulation of a sugar called sorbitol and depletion of a substance called myoinositol. These changes are the mechanism that causes nerve damage. Nitric oxide dilates blood vessels. In a person with diabetes, low levels of nitric oxide may lead to constriction of blood vessels supplying the nerve, contributing to nerve damage.
3. Presence of mechanical injury like carpal tunnel syndrome in a diabetic patient worsens its symptoms and prognosis
4. Inherited traits increase susceptibility to nerve disease
5. Lifestyle factors, such as smoking or alcohol use

Symptoms:

1. Numbness, burning sensations, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
2. Either hypersensitivity to touch or insensitivity, even to hot and cold temperatures
3. Weakness in muscles and loss of reflexes
4. Indigestion, nausea, or vomiting
5. Diarrhea or constipation
6. Dizziness or faintness due to a drop in blood pressure after standing or sitting up
7. Problems with urination
8. Changes in gait and balance
9. Injuries that are taking longer to heal and are more prone to infections

Prevent Diabetic Nerve Damage-

Keeping your blood sugar levels in your target range, set with your doctor, may help prevent nerve damage from ever developing. The best way to do this is by checking your blood sugar and adjusting your treatment. It is also important to get to and stay at a healthy weight by exercising and eating healthy foods.

In case you have a concern or query you can always consult an expert & get answers to your questions!