Diabetes Special Report
Diabetic Neuropathy: An Underdiagnosed Complication
Diabetic neuropathy is a serious and common complication of diabetes. But it's not inevitable. People in the Diabetes Complications and Control Trial (DCCT) who received intensive insulin therapy and maintained tight glucose control reduced their risk of neuropathy by 60%. As with many diabetic complications, prevention is key.
If knowledge is power, as the old saying goes, too many people with diabetes are not adequately armed for battle. A survey by the American Diabetes Association found that 56% of respondents with diabetes had never heard of diabetic neuropathy -- the nerve damage that is one of the disease's most common and crippling complications -- even though many had experienced symptoms of neuropathy.
Even more troubling, some studies have found that doctors often miss diabetic neuropathy during exams or fail to adequately screen for the condition, which could allow a mild case of neuropathy to worsen.
Diabetes and Your Nervous System
Think of the nervous system as the body's communication network, with the nerves serving as transmission lines that relay information back and forth between the brain and every muscle and organ in your body. When nerves become damaged, signals traveling along these transmission lines may be delayed or blocked altogether.A number of factors combine to cause nerve damage in people with diabetes. One of the most important is poor blood glucose control: High glucose levels over the years will harm your nerves.
Signs and Symptoms of Neuropathy
By far, the most common form of nerve damage in people with diabetes is peripheral neuropathy, which commonly causes numbness, pain, or a tingly, "pins-and-needles" feeling in the toes and feet. These feelings can progress up to the legs and even the hands.Why are the toes and feet affected first? If you think of your nerves as electrical wires, then it's not surprising that the longest nerves in your body -- the ones that travel from your brain to your toes -- have the most potential to go bad first.
There are other, less common forms of neuropathy, especially one called autonomic neuropathy. It can injure the "autonomic" nerves, which regulate bodily functions you do not consciously control, such as heart rate, blood pressure, and digestion. Autonomic neuropathy can produce an array of problems. Some of the most common are:
- Erectile dysfunction in men and vaginal dryness in women
- Diarrhea, constipation, and other digestive problems
- Poor bladder control and frequent urinary tract infections
- Poor night vision
- Excessive sweating at night or while eating salty, sweet, or spicy foods
- Dizziness or lightheadedness upon standing
- A rapid heart rate (more than 100 beats per minute at rest)
Diagnosing Diabetic Neuropathy
Diabetic neuropathy is certainly not the only cause of these symptoms, but if you have diabetes, there's a chance that your elevated blood glucose levels may be to blame. Your doctor can spot many forms of diabetic neuropathy simply by asking about symptoms and performing a physical exam and certain tests.
Because nerve damage develops slowly, you may not realize that it is happening. That's why it's important to have regular exams to catch nerve damage in its early stages, before it causes problems such as a foot ulcer or infection. It's also important to tell your doctor if you experience any of the signs and symptoms of neuropathy.
Posted in Diabetes on May 15, 2008
