What is Neuropathy?
One of the most potentially devastating diabetes complications is neuropathy. Neuropathy is not a single condition, nor is it a complication which is exclusive to diabetes (nor high blood sugar) – but it is a very common complication of diabetes and of long term smoking. In essence, neuropathy is damage to many of the various nerves in our bodies. These are nerves that control how we feel the world, how we keep balance, and even how we perform certain bodily functions.
There are different kinds of neuropathy, depending on the types of nerves that are damaged.
Peripheral neuropathy is characterized by damage to the peripheral nerves that are in our extremities, such as hands and feet. Many people who experience neuropathy report feeling tingling, numbness, pins and needles, heat, oversensitivity to touch, coordination problems while walking, etc. Because our various nerves serve different functions and receive information differently – what we feel as damage from neuropathy might be different from what the next person feels, depending on which nerves are damaged. Therefore, no single symptom is enough on its own to diagnose neuropathy, but a combination of these symptoms might be cause for concern. Another symptom of neuropathy or nerve damage to our extremities is the development of foot ulcers, and slow healing wounds, which if untreated, may lead to amputation. If you suspect you may have neuropathy, it is important to ask for a referral to a neurologist.
Autonomic neuropathy is characterized by damage to the nerves which control many of the functions of our internal organs, such as our eyes, heart, lungs, bladder, and stomach. A person with autonomic neuropathy might develop visual impairment issues (and even blindness), problems properly digesting food and emptying their stomachs, they might develop incontinence, or they might even develop sexual performance issues such as erectile dysfunction.
Intervention for these conditions is often invasive, and may require surgery, such as the implanting of a special device to help handle reduced function of the stomach due to nerve damage (a condition called gastroparesis.)
Diagnosis and prevention
If you suspect you might have problems with neuropathy or retinopathy (nerve damage in your eyes) it is imperative that you contact your medical team. Diagnosing neuropathy often requires nerve conduction studies, electromyography, ultrasounds, or special eye exams, etc.
We may reduce risk of developing neuropathy (or manage already present neuropathy) by:
- Keeping blood glucose levels within range;
- Exercising regularly to help circulation;
- Avoiding smoking and drinking excessively; and
- Eating a well balanced diet.
Even with these precautions, we might still develop neuropathy because of a genetic predisposition. It is therefore important we regularly check our feet, get regular eye exams, and report any ‘off’ symptoms we might be having to our medical team.
If you already have neuropathy, remember to keep your glucose levels under control, protect your feet, and consult your medical team for various pain management options.
What aspect of diabetes management do you struggle with most?