Diabetic Neuropathy: Types, Causes, Diagnosis & Treatment

Diabetes can cause diabetic neuropathy, which is a type of nerve injury. Increased blood sugar (glucose) levels can cause nerve damage. Diabetic neuropathy mostly affects nerves in the feet and legs.

Diabetic neuropathy symptoms include discomfort and numbness in the legs, feet, and hands, depending on the nerves involved. It can also cause digestive, urinary tract, blood vessel, and cardiac problems. Some folks just have minor symptoms. Diabetic neuropathy, on the other hand, can be extremely unpleasant and devastating for some people.

Diabetic neuropathy is a significant diabetes complication that affects up to half of all people with diabetes. However, with continuous blood sugar tests and a healthy lifestyle, you can typically prevent or halt the progression of diabetic neuropathy.

Types of Diabetic Neuropathy

Various types of nerve injury are referred to as neuropathy. There are four major forms of neuropathy in diabetics.

  1. Autonomic 

Autonomic diabetic neuropathy is the second most prevalent kind of neuropathy among people with diabetes. The autonomic nervous system controls other systems in your body that you are unaware of. Some of the signs of a heart attack can be difficult to spot if you have autonomic neuropathy. When your heart does not receive enough oxygen, you may not experience any chest pain.

  1. Proximal

Proximal diabetic neuropathy, commonly known as diabetic amyotrophy, is an uncommon type of neuropathy. This type of neuropathy is more common in persons over 50 with well-controlled type 2 diabetes and men.

It frequently affects the hips, buttocks, and thighs. You may feel sharp and sometimes intense pain. Leg muscle weakness may make standing up without assistance difficult. Typically, diabetic amyotrophy damages only one side of the body.

  1. Peripheral

Peripheral diabetic neuropathy is the most prevalent type of neuropathy. Peripheral neuropathy is most commonly found in the feet and legs, but it can also occur in the arms or hands. The symptoms range from moderate to severe.

You may not notice an injury or discomfort on your foot if you have peripheral neuropathy. Diabetes patients frequently have impaired circulation, making wound healing more challenging. This combination raises the possibility of infection. In severe circumstances, an infection can result in amputation.

  1. Focal

Focal diabetic neuropathy, also known as mononeuropathy, occurs when a single nerve or group of nerves is damaged, resulting in weakness in the afflicted area. This most commonly occurs in your hand, head, torso, or leg. It frequently arises unexpectedly and is excruciatingly painful. Some symptoms include – Bell’s Palsy, Double Vision, and Inability To Focus.

Causes of Diabetic Neuropathy

Diabetic neuropathy is characterised by elevated blood sugar test levels that are sustained over time. Other things that can cause nerve injury include:

  • High cholesterol levels induce blood vessel damage.
  • mechanical injury, such as carpal tunnel syndrome injuries
  • Smoking and alcohol consumption are examples of lifestyle influences.

Low vitamin B-12 levels can potentially cause neuropathy. Metformin, a commonly used diabetes treatment, can lower vitamin B-12 levels. You can request a simple blood sugar test from your doctor to determine any vitamin deficits.

Diagnosis of Diabetic Neuropathy

In addition to the physical exam, your doctor may order other tests to help identify diabetic neuropathy, such as:

  • Filament evaluation: To assess your sensitivity to touch, a delicate nylon fibre (monofilament) is rubbed over parts of your skin.
  • Sensory evaluation: This noninvasive test determines how your nerves react to vibration and temperature changes.
  • Nerve conduction analysis: This test assesses the speed with which the nerves in your limbs conduct electrical signals.
  • Electromyography: This examination, known as needle testing, is frequently performed in conjunction with nerve conduction investigations. It detects electrical discharges in your muscles.
  • Testing of autonomic function: Special tests may be performed to assess how your blood pressure changes while in different positions, and whether your sweating is within the normal range.

Treatment of Diabetic Neuropathy

There is no recognised cure for diabetic neuropathy. The treatment’s objectives are-

  • Ensuring the progression is slow. 
  • Pain relief
  • Manage difficulties and reestablish functionality.

The majority of diabetic neuropathy worsens with time.

The first step for persons of any type is to bring blood sugar levels within a goal range agreed upon by a doctor and manage excessive blood pressure and cholesterol levels. Controlling glucose levels reduces the incidence of diabetic neuropathy. A critical aspect of treatment is reducing discomfort and managing some of the symptoms.

Along with other therapies, reliable sources and types of physical rehab can help manage the pain of diabetic neuropathy. They cannot, however, restore the nerves. People should also avoid or stop smoking and limit their alcohol consumption to one drink for women and two drinks per day for males