Table of Contents
Introduction
With the increase in the diabetic population worldwide (about 425 million), its complications are also rising at the same rate. One of the most concerning complications of diabetes is diabetic neuropathy, affecting more than 40 million people globally. Diabetic neuropathy is also responsible for about 40 to 60 percent of lower extremity amputations. This article discusses diabetic neuropathy in detail, including its signs and symptoms, treatments, and more. If you are interested in learning about diabetic neuropathy, keep scrolling…
In diabetes, there is a honeymoon phase that lasts between 10 and 15 years. During this phase, no major diabetic complications are typically seen, even if blood sugar levels reach 250 to 300. However, after this honeymoon phase, major diabetic complications can arise. There are two mechanisms involved in these complications: macrovascular and microvascular.
Macrovascular Complications in Diabetes
In macrovascular complications, the major problem is associated with the arterial system. Atherosclerosis, which is the accumulation of cholesterol in the arteries, is a key issue. It is said that atherosclerosis begins when a baby is still in the mother’s womb. In patients with diabetes, obesity, or those who smoke, this process accelerates 5 to 7 times faster than in a normal individual. This rapid accumulation of cholesterol and calcium in the arterial walls can lead to heart attacks. If it occurs in the brain’s arteries, it can cause a stroke, and in the leg arteries, it can lead to gangrene.
Microvascular Complications in Diabetes
Microvascular complications are mostly associated with small arteries, affecting the retina, kidneys, and limbs. They are broadly classified as retinopathy, nephropathy, and neuropathy. In retinopathy, the retina is affected, potentially leading to blindness. Nephropathy impacts the kidneys, where nephrons fail to filter proteins, causing creatinine levels to rise. In severe cases, the kidneys fail to filter blood, requiring dialysis or transplantation. Diabetic neuropathy is a condition where the nerves in the feet are damaged.
What is Diabetic Neuropathy?
As the name suggests, when diabetes affects the nerves of the body, it is called diabetic neuropathy. Unlike other organs affected by diabetes, such as the eyes and kidneys, where the symptoms are quite predictable, neuropathy is a complex condition with multiple types. When diabetes affects the eyes, symptoms are quite visible, such as bleeding in the eyes and leaking blood vessels. Similarly, when diabetes affects the kidneys, proteins start leaking into the urine (small quantities of albumin), among other symptoms. In other words, when the eyes and kidneys are affected, the symptoms are quite predictable.
In about 50 percent of cases, neuropathy remains asymptomatic. For instance, sometimes neuropathy can affect just the sensation, known as peripheral neuropathy, which impacts the sensory system. Now the question is, what happens when the sensory system is affected? In peripheral neuropathy, nerves can be affected anywhere in the body. However, when the nerves in the feet are affected, the sensation in the feet slowly diminishes.
What Happens When the Feet Sensation Goes Away?
When a person with neuropathy steps on a nail, they may not realize it, even though there is blood coming from their foot. They will only become aware when someone else points it out to them. In a normal situation, if a person steps on a nail or even a pebble, they will immediately withdraw their foot from the object. However, people with neuropathy may not realize it, and this foot injury could lead to a foot ulcer. If this ulcer does not heal, it could result in a severe foot infection, potentially leading to gangrene and eventually necessitating amputation.
What if Neuropathy Leads to Affecting the Motor System?
When neuropathy affects the motor system, it impacts the muscles and can lead to several complications. For instance, a person with neuropathy may develop foot drop, where the foot drags because a nerve is affected, eventually impacting the muscles. In severe cases, it could lead to claw foot or significant damage to the foot itself. It is important to note that these complications arise only in severe neuropathy. Properly managed diabetes can prevent these situations, allowing a person with diabetes to live a normal life.
Causes of Diabetic Neuropathy
There are several causes of diabetic neuropathy, but the two most common causes are mentioned below:
- Uncontrolled blood sugar level in a diabetic person
- High levels of fats (triglycerides)
If the above two factors remain uncontrolled for a long period of time, they can damage nerve cells. Additionally, high blood glucose levels are also responsible for damaging small blood vessels. These blood vessels are responsible for nourishing nerves with nutrients and oxygen. If they get damaged, nerves do not receive an ample amount of oxygen and nourishment. As a result, nerves fail to function normally.
How to Prevent Diabetic Neuropathy?
Diabetes is a lifestyle disease. And if someone has diabetes, then he or she should know how to manage it. In other words, a person with diabetes must know how to control blood sugar. This can be achieved by changing the lifestyle. Some of the actions that can be taken to manage diabetes include:
- Physical activity
- Follow a proper meal plan
- Stop drinking and smoking
- Stress management
- Take medications as prescribed by the doctor
How to Prevent Diabetic Neuropathy from Progressing?
If someone has diabetic neuropathy, it means they likely have uncontrolled blood sugar, blood pressure, cholesterol levels, and weight. The first and foremost step is to control these parameters through lifestyle changes and medications. Additionally, foot care is very important for diabetic patients. Check your feet every day, and if there is any injury, consult a doctor to heal the injury.
Who is at Risk of Diabetic Neuropathy?
When a person has diabetes for a longer period of time and does not manage it well, they are more likely to develop diabetic neuropathy. The chances of having diabetic neuropathy increase if a person with diabetes also has:
- Overweight
- HBP (High Blood Pressure)
- High Cholesterol
- Advanced kidney disease
- Smoking and Drinking habits
FAQs (Frequently Asked Questions)
Q. What is diabetic neuropathy?
A. It is a condition in which the nerves get damaged due to diabetes mellitus.
Q. How common is the occurrence of diabetic neuropathy?
A. About 60 percent of people may suffer from neuropathy within 10-15 years of the diagnosis of their diabetes only if they fail to control their blood sugar, cholesterol level, and obesity.
Q. Can diabetes neuropathy be prevented?
A. Yes, it can be cured with diabetes management.