Diabetes Complications of the Nerves
We work at managing diabetes for one major reason – to avoid, or at least postpone, long term diabetes-related “complications.” Long-term complications arise over time as persistent high blood glucose levels damage blood vessels, particularly those ultra-small blood vessels called “capillaries.” Capillaries deliver oxygen and “food” to, and remove waste products from, individual cells. When the capillaries that sustain nerve cells are damaged, the function of the nerves themselves is disrupted.
Damage to nerves is called “neuropathy,” and there are a number of diabetes-related neuropathies worth noting, divided into two broad categories as follows:
- Sensory/motor neuropathy affects those nerves associated with our sense of feel (sensory) or the nerves that signal muscles to contract (motor). Sensory neuropathy is a very common diabetes-related complication marked by numbness, tingling or pain especially in those areas where blood vessels are near the “end of the line” – hands and feet (called peripheral neuropathy). A secondary serious affect of peripheral neuropathy is an inability to detect the pain of injury of infection. Motor neuropathy can result in muscle weakness (foot drop is common), trouble with mobility, and even double vision.
- Autonomic neuropathy affects those nerves that send signals regulating processes we don’t think about – breathing, heart rate, digestion, sexual response, etc. Gastroparesis, for example, is a diabetes-related complication which inhibits digestive functions, like stomach emptying. Autonomic neuropathies can result in sexual dysfunction, problems with bladder emptying, episodes of unexplained diarrhea, and issues with heart rhythm and blood pressure.
Neuropathies are generally not life threatening, but can have a massive impact on quality of life. Plus, neuropathies can contribute to more serious issues (foot infection), and complicate diabetes management with diet and exercise. While some treatments and techniques are available to reduce symptoms, diabetes-related neuropathies cannot be reversed. Preventing neuropathies (and preventing existing neuropathies from getting worse) is all about controlling average high blood glucose levels with diet, exercise and medication. Studies show a clear correlation between A1C and diabetes-related complications, and that’s why day to day diabetes management is so important over the long run.
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