what is diabetic ?

Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet.

Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your legs and feet to problems with your digestive system, urinary tract, blood vessels and heart. Some people have mild symptoms. But for others, diabetic neuropathy can be quite painful and disabling.

Diabetic neuropathy is a common and serious complication of diabetes. But you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.

Signs and symptoms :

Peripheral Neuropathy symptoms:

Numbness or reduced ability to feel pain or temperature changes.
Tingling or burning sensation.
Sharp pains or cramps.
Increased sensitivity to touch — for some people, even the weight of a bedsheet can be painful.
Muscle weakness.

Autonomic Neuropathy symptoms :

This type usually affects the digestive system, especially the stomach. It can also affect the blood vessels, urinary system, and sex organs.

Bloating
Diarrhea
Constipation
Heartburn
Nausea
Vomiting
Feeling full after small meals

Radiculoplexus neuropathy :
Severe pain in a hip and thigh or buttock that occurs in a day or more
Eventual weak and shrinking thigh muscles
Difficulty rising from a sitting position
Abdominal swelling, if the abdomen is affected
Weight loss

Mononeuropathy:

Shin or foot
Lower back or pelvis
Front of thigh
Chest or abdomen
Difficulty focusing
Double vision
Aching behind one eye
Paralysis on one side of your face (Bell's palsy)

Causes:

Damage to nerves and blood vessels
The exact cause likely differs for each type of neuropathy. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients.

However, a combination of factors may lead to nerve damage, including:

Inflammation in the nerves caused by an autoimmune response. The immune system mistakes nerves as foreign and attacks them.
Genetic factors unrelated to diabetes may make some people more likely to develop nerve damage.
Smoking and alcohol abuse damage both nerves and blood vessels and significantly increase the risk of infection.

Diagnosis:

A doctor can usually diagnose diabetic neuropathy by performing a physical exam and carefully reviewing your symptoms and medical history.

Your doctor will check your:

Overall muscle strength and tone
Tendon reflexes
Sensitivity to touch and vibration
Also at every visit, your doctor should check your feet for sores, cracked skin, blisters, and bone and joint problems. The American Diabetes Association recommends that all people with diabetes have a comprehensive foot exam at least once a year.

Along with the physical exam, your doctor may perform or order specific tests to help diagnose diabetic neuropathy, such as:

Filament test. Your doctor will brush a soft nylon fiber (monofilament) over areas of your skin to test your sensitivity to touch.
Quantitative sensory testing. This noninvasive test is used to tell how your nerves respond to vibration and changes in temperature.
Nerve conduction studies. This test measures how quickly the nerves in your arms and legs conduct electrical signals. It's often used to diagnose carpal tunnel syndrome.
Electromyography (EMG). Often performed along with nerve conduction studies, EMG measures the electrical discharges produced in your muscles.
Autonomic testing. If you have symptoms of autonomic neuropathy, special tests may be done to determine how your blood pressure changes while you are in different positions, and whether you sweat normally.

Prevention:

You can prevent or delay diabetic neuropathy and its complications by keeping tight control of your blood sugar and taking good care of your feet.

Blood sugar control
Use an at-home blood sugar monitor to check your blood sugar and make sure it consistently stays within target range. It's important to do this on schedule. Shifts in blood sugar levels can accelerate nerve damage.

The American Diabetes Association recommends that people with diabetes have the A1C test at least twice a year. This blood test indicates your average blood sugar level for the past two to three months. If your blood sugar isn't well-controlled or you change medications, you may need to get tested more often.

Foot care
Follow your doctor's recommendations for good foot care.

Foot problems, including sores that don't heal, ulcers and even amputation, are a common complication of diabetic neuropathy. But you can prevent many of these problems by having a comprehensive foot exam at least once a year, having your doctor check your feet at each office visit and taking good care of your feet at home.

To protect the health of your feet:

Check your feet every day. Look for blisters, cuts, bruises, cracked and peeling skin, redness, and swelling. Use a mirror or ask a friend or family member to help examine parts of your feet that are hard to see.
Keep your feet clean and dry. Wash your feet every day with lukewarm water and mild soap. Avoid soaking your feet. Dry your feet and between your toes carefully by blotting or patting with a soft towel.

Moisturize your feet thoroughly to prevent cracking. Avoid getting lotion between your toes, however, as this can encourage fungal growth.

Trim your toenails carefully. Cut your toenails straight across, and file the edges carefully so there are no sharp edges.
Wear clean, dry socks. Look for socks made of cotton or moisture-wicking fibers that don't have tight bands or thick seams.
Wear cushioned shoes that fit well. Always wear shoes or slippers to protect your feet from injury. Make sure that your shoes fit properly and allow your toes to move. A podiatrist (foot doctor) can teach you how to buy properly fitted shoes and to prevent problems such as corns and calluses.

If problems do occur, your doctor can help treat them to prevent more-serious conditions. Even small sores can quickly turn into severe infections if left untreated.

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