Diabetic Complications: Neuropathy or Nerve Damage.

Bristol Diabetes . Access . Complications
Diabetic Neuropathy is the medical term for nerve damage caused by diabetes.

Causes of Nerve Damage (Neuropathy).

Like many of the complications of diabetes, nerve damage is related to the circulatory system. Nerve damage begins when the small blood vessels fail to deliver food (glucose), nutrients and oxygen to the nerves.

High blood glucose levels are thought to be the cause of this with high levels leading to narrowing or blockage of the small blood vessels feeding the nerves. This leads ultimately to starvation of the nerves.

Damaged nerves seldom regenerate and only the most recent damage can be reversed by good blood glucose control, so lost sensation is generally not regained.

External Links

  • Foot Pain, a great deal of information all on one page. General information first then diabetes related.
  • Neuropathy

Peripheral Neuropathy

Peripheral Nerve Damage starts in the toes and feet.Neuropathy in the hands usually only occurs after foot problems have occured. This is the commonest form of nerve damage. As the name indicates it occurs in the extremities most often in the feet (especially the toes) and much less often in the hands.

Early symptoms can be pins and needles and cramp which if blood sugar control is poor may lead to numbness, loss of sensation or pain in the feet and toes.

Symptoms are symmetric, so for example: peripheral neuropathy in the feet would affect both feet. Symptoms are often worse at night.

Infection after accidental damage can lead to foot ulcers and gangrene.

The current advice where some sensation has been lost in the feet is -

  1. Do not self treat corns or injuries to feet.
  2. Make regular visits to a foot care specialist.
  3. Wear well fitting supporting footwear (lace ups are recommended).
  4. Check feet every day.
  5. Check for sharp objects inside shoes.
  6. Don't go bare foot.
  7. Keep feet dry to reduce risk of fungal infections like athlete's foot.

Cushion-soled trainers are recommended if foot ulcers or foot infections are present.

External Links

Minimising the Risks

Some people are however more susceptible to Neuropathy than others for reasons which are at present unknown.

Focal Neuropathy

Focal Neuropathy affects specific nerves and appears suddenly. It can affect vision (causing difficulty in focusing or double vision), hearing, cause facial paralysis on one side of the face (Bell's Palsy) or pain (in the inner thigh, pelvis, lower back, chest, stomach, flank, shin or the inside of the foot).

Unlike Peripheral Neuropathy however it seems to cause no long term damage and individual attacks gradually improves with time.

Autonomic Neuropathy

Autonomic neuropathy can affect - The Heart, Lungs, Digestion, Sexual Organs (causing impotence in men), Sweat glands & Bladder.

Autonomic problems may be indicated if there is a fast heart rate or a fall in blood pressure on standing (indicated by fainting, feeling light headed or dizzy).

Autonomic Digestive problems are likely to cause blood sugar control to get worse with stomach bloating, constipation or diarrhea.

Treatments for Neuropathy

These are treatments for the symptoms not curing the root problem. The best way of reducing the risk of Neuropathy from developing or getting worse is through good blood sugar control and exercise.

Exercise flushes out the toxins including excess glucose that tend to build up in the 'backwaters' of the circulatory system. It also improves the circulation generally helping improve blood supply in the extremities.

Pain Relief starting from mild painkillers like aspirin and paracetamol to the more powerfull painkillers. Others forms of pain relief are nerve controlling drugs like Gabapentin and Capsaicin Cream.

Creams & Barriers to protect sensitive skin, wearing socks in bed for instance.

External Link