One
of the more problematic complications of diabetes is diabetic
neuropathy. It is a type of nerve damage where high blood sugars can
damage the nerves most often in your feet and legs. Diabetic
neuropathy can affect nerves in your entire body ranging from mild
problems to painful that can be disabling or fatal.
There
are four main types
of diabetic neuropathy. All are the result of neglect of or poor
diabetes management. You may have just one type or symptoms of
several types. Most develop gradually, and you may not notice
problems until considerable damage has occurred. For some people with
type 2 diabetes, symptoms of neuropathy develop before diabetes is
ever diagnosed. How well I know this as I had this at least four
years before I was diagnosed.
Peripheral neuropathy.
Peripheral neuropathy is the most common form. It affects the very
ends of nerves first, starting with the longest nerves. That means
your feet and legs are often affected first, followed by your hands
and arms.
Signs
and symptoms of peripheral neuropathy include - numbness or reduced
ability to feel pain or changes in temperature, especially in your
feet and toes. It can be a tingling or burning feeling or a sharp,
jabbing pain that may be worse at night. It may be a pain when
walking, extreme sensitivity to the lightest touch, and for some
people, even the weight of a sheet can be agonizing. It can be
muscle weakness and difficulty walking, serious foot problems, such
as ulcers, infections, deformities, and bone and joint pain.
Autonomic neuropathy. The
autonomic nervous system controls your heart, bladder, lungs,
stomach, intestines, sex organs and eyes. Diabetes can affect the
nerves in any of these areas, possibly causing - a lack of awareness
that blood sugar levels are low (hypoglycemia unawareness). Bladder
problems, including frequent urinary tract infections or urinary
incontinence, constipation, uncontrolled diarrhea or a combination of
the two may also happen. Slow stomach emptying (gastroparesis),
leading to nausea, vomiting and loss of appetite is not uncommon.
Erectile dysfunction in men, vaginal dryness and other sexual
difficulties in women, increased or decreased sweating, and the
inability of your body to adjust blood pressure and heart rate. This
leads to sharp drops in blood pressure when you rise from sitting or
lying down (orthostatic hypotension) that may cause you to feel
lightheaded or even faint, and problems regulating your body
temperature. It may cause changes in the way your eyes adjust from
light to dark, difficulty exercising, and increased heart rate when
you're at rest.
Autonomic
neuropathy is most likely to occur in people who have had poorly
controlled diabetes for many years.
Radiculoplexus neuropathy
(diabetic amyotrophy). Instead
of affecting the ends of nerves, like peripheral neuropathy,
radiculoplexus neuropathy affects nerves closer to your hips or
shoulders. Also called diabetic amyotrophy, femoral neuropathy, or
proximal neuropathy, this condition is more common in people with
type 2 diabetes and older adults. Though the legs are affected more
often, this type of neuropathy may affect nerves in the arms or even
the abdomen. Symptoms are usually on one side of the body, though in
some cases symptoms may spread to the other side too. Most people
improve at least partially over time, though symptoms may worsen
before they get better.
This
condition is often marked by - sudden, severe pain in your hip and
thigh or buttock; eventual weak and atrophied thigh muscles;
difficulty rising from a sitting position; unintentional weight loss;
abdominal swelling, if the abdomen is affected.
Mononeuropathy. The
term mononeuropathy means damage to just one nerve. The nerve may be
in the arm, leg or face. Mononeuropathy, which may also be called
focal neuropathy, often comes on suddenly. It's most common in older
adults. Mononeuropathy can cause severe pain, but it usually does not
cause any long-term problems. Symptoms usually diminish and disappear
on their own over a few weeks or months.
Signs
and symptoms depend on which nerve is involved and may include -
difficulty focusing your eyes, double vision or aching behind one
eye; paralysis on one side of your face (Bell's palsy); pain in your
shin or foot; pain in the front of your thigh; chest or abdominal
pain.
Mononeuropathy
occurs when a nerve is compressed. Carpal tunnel syndrome is a common
type of compression neuropathy in people with diabetes. Signs and
symptoms of carpal tunnel syndrome include - numbness or tingling in
your fingers or hand, especially in your thumb, index finger, middle
finger and ring finger; a sense of weakness in your hand and a
tendency to drop things; worsening of symptoms upon awakening or
while gripping something.
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