What is Diabetic Peripheral Neuropathy?

Diabetic peripheral neuropathy explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

Diabetic Peripheral Neuropathy DiagramDiabetes, or diabetes mellitus, is a metabolic disease that causes patients to have a high concentration of glucose in their blood (blood sugar). This disease can be a result of insufficient insulin production within the body or a failure of the body’s cells to react properly to insulin.

Most diabetes is classified as Type 1 or Type 2. Type 1 diabetes is also known as juvenile diabetes, and usually begins to affect patients before the age of thirty, although diagnosis of the condition can be made at any age. Patients develop Type 1 diabetes when there is insufficient insulin secreted by the pancreas. The symptoms of this type of diabetes include high blood sugar, impaired vision, thirst, weight loss, and increased urination. These symptoms usually present suddenly with little warning. Type 2 diabetes is also referred to as adult onset diabetes. This condition develops either when the pancreas fails to produce sufficient insulin or when cells fail to respond to insulin. Type 2 diabetes frequently develops in obese patients, and is characterized by symptoms similar to those seen in Type 1 diabetes, but may present more gradually.

Diabetic patients often develop diabetic peripheral neuropathy. This condition is due to nerve damage in the hands, arms, legs, and feet. Approximately half of all diabetic patients develop diabetic peripheral neuropathy. This complication can be distinguished from peripheral arterial disease, which is due to poor circulation, because the nerves are affected rather than the blood vessels.

Diabetic Peripheral Neuropathy BreakdownDiabetic peripheral neuropathy is characterized by a loss of sensation beginning in the toes that spreads upward into the arms and hands. These symptoms often increase at night. Patients experiencing such loss of sensation become more vulnerable to skin ulcers (open sores) and other complications. Diabetic peripheral neuropathy may not present symptoms immediately. There is usually a gradual onset of symptoms that come over time. Diabetic peripheral neuropathy can affect a patient’s sensory, autonomic, and motor nerves. Patients with diabetic peripheral neuropathy may experience a variety of symptoms, such as numbing or tingling sensation in the toes, feet, legs, fingers, hands, and arms. Episodes of extreme pain may occur; however, some patients remain asymptomatic. Longevity of diabetic peripheral neuropathy can cause complications that may result in skin ulcers and infections.

Causes of Diabetic Peripheral Neuropathy

Diabetic Peripheral Neuropathy MassageThe persistent exposure of nerve fibers in the limbs to the high blood glucose levels characteristic of diabetes can damage the nerves, resulting in diabetic peripheral neuropathy. Elevated blood glucose levels affect the transmission of nerve sensations. In addition the high concentration of blood glucose can injure the surrounding blood vessels that nourish and oxygenate the nerves.

Diabetic peripheral neuropathy is also promoted by genetic factors, inflammation of the nerves due to autoimmune reactions, and the persistent use of tobacco and alcohol. Diabetic peripheral neuropathy is commonly found in patients with poorly managed diabetes. However, patients that are able to maintain proper blood glucose levels may also experience this complication.

Treatments for Diabetic Peripheral Neuropathy

A patient’s self-management of their diabetic condition is the cornerstone of treatment for those diagnosed with diabetic peripheral neuropathy. Extensive monitoring every four to six weeks is required for assessing any therapeutic regimen and patient recovery. Regular foot examinations can significantly lower the incidence of skin ulcers and infections.

AcupunctureTreatment for diabetic peripheral neuropathy requires glycemic control. Radical oscillations in blood glucose levels are thought to irritate the nerves and increase the level of pain. Moderate painful symptoms can be managed by the use of over-the-counter medications for pain. Wearing loose-fitting clothing and shoes with extra support is also helpful.

Diabetic neuropathy can also be treated with tricyclic medications. These drugs can effectively manage painful symptoms; however, some patients experience adverse reactions with such medicines. Acupuncture and vitamin supplements often benefit diabetic peripheral neuropathy patients by providing long-term pain relief. These therapeutic modalities are recommended for patients who wish to avoid the use of prescription drugs. Spinal cord stimulation and other complex procedures can also be administered to patients experiencing extreme pain from diabetic neuropathy.

Conclusion

Diabetic peripheral neuropathy frequently develops in patients with diabetes. This condition often results in the loss of feeling in the upper and lower extremities, and patients may experience chronic pain. There are many treatment options available for diabetic peripheral neuropathy. Patients with diabetic neuropathy must maintain strict glycemic control under the supervision of their physician. The symptoms can be managed with proper monitoring and treatment.

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References

  1. Abusaisha BB, Constanzi JB, Boulton AJM: Acupuncture for the treatment of chronic painful diabetic neuropathy: a long-term study. Diabetes Res Clin Pract. 1998;39:115-121.
  2. Dyck PJ, Katz KM, Karnes JL, Litchy WJ, Klein R, Pach JM: The prevalence by staged severity of various types of diabetic neuropathy, retinopathy and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy study. Neurology. 1993;43:817-824.
  3. Mendell JR, Sahenk Z: Painful sensory neuropathy. N Engl J Med. 2003;348 :1243-1255.
  4. O’Brien SP, Schwedler M, Kerstein MD. Peripheral neuropathies in diabetes. Surg Clin North Am. 1998;78(3):393-408.
  5. Possidente CJ, Tandan R. A survey of treatment practices in diabetic peripheral neuropathy. Prim Care Diabetes. 2009;3(4):253-7.
  6. Skyler JS. Diabetic complications. The importance of glucose control. Endocrinol Metab Clin North Am. 1996;25(2):243-54.
  7. Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu-Tirgoviste C, et al. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005;352(4):341-50.
  8. Veves A, Backonja M, Malik RA. Painful diabetic neuropathy: epidemiology, natural history, early diagnosis, and treatment options. Pain Med. 2008;9(6):660–674.