Symptoms of the Different Types of Diabetic Neuropathy

You've been feeling that numbness at your toes for more than a couple of weeks now. The numbness comes with a peculiar feeling of tingling burning sensation. At night, a sharp jabbing pain at your feet wakes you up. You have difficulty in walking due to pain. Worse, you can't distinguish between cold or hot and your extremities don't have any feeling at all. It can be terrifying! Actually, it's one more complication of your diabetes.

Peripheral Neuritis (pronounced /new.righ'tis/)

Peripheral neuritis is the most common type of neuropathy (pronounced /new.rop'uth-ee/) occurring among diabetics. It affects your toes, feet and later your arms and hands. As you lose your capacity to feel any pain in your extremities serious complications set in. You can hurt your foot on something without knowing it. An open wound results. Too much sugar in your blood sets the stage for infection. Then, it leads to ulceration and deformities. When necrosis or tissue death occurs, your leg will have to be amputated.

The manifestations of other types of neuropathy depend upon what types of nerves are affected. Apart from peripheral neuritis other types of diabetic neuropathy are autonomic (pronounced /aw''tuh.nom'ick/) neuropathy, radiculoplexus (pronounced /ra.dick''yoo.lo.pleck'sus/) neuropathy and mononeuropathy (pronounced /mon''o-new.rop'uth-ee/).

Autonomic Neuropathy

Autonomic neuropathy affects the nerves controlling the functions of your body organs. Your autonomic nervous system is responsible in the functioning of your heart, lungs, stomach, intestines, sex organs, bladder and eyes. When the nerves of your bladder are affected you'll experience urinary incontinence. On the other hand, when your stomach nerves are involved you'll feel slow stomach emptying termed as gastroparesis with nausea, loss of appetite and vomiting. Constipation or uncontrolled diarrhea can also be symptoms.

When the nerves of sex organs are involved, males suffer erectile dysfunction while females sexual difficulties.

The nerves of your heart can be affected too and your body will have difficulty in adjusting to blood pressure and heart rate. You'll feel a fast heart rate at rest. You'll undergo a sudden drop in blood pressure from a sitting to a standing position that can cause faintness or lightheadedness.

There would be problems regulating your body temperature. If your eye nerves are affected, you'll have trouble adjusting from light to dark. Dangerously, your body might not detect low blood sugar levels. When this happens, weakness or fatigue sets in. In extreme cases, hypoglycemic coma can occur.

Radiculoplexus Neuropathy

Radiculoplexus neuropathy is also termed as diabetic amyotrophy (pronounced /am''eye.ot'ruh.fee/), femoral neuropathy or proximal neuropathy. It affects the nerves in your thighs, hips, buttocks or legs. The symptoms appear suddenly and severely. The muscles affected become weak then atrophy and you'll have to struggle rising from a sitting position. If your abdomen is affected swelling occurs. Over time, weight loss ensues.

Mononeuropathy

Mononeuropathy involves damage to a specific nerve. When your facial nerve is affected, paralysis of one side of your face occurs termed as Bell's palsy. Other symptoms include pain in your foot, shin and front of thigh; difficulty focusing your eyes, double vision and pain behind your eye; chest or abdominal pain. Compression neuropathy can happen such as in carpal tunnel syndrome. You'll feel numbness and tingling especially in your thumb, index, middle or ring fingers plus weakness in your hand.

Why Neuropathy Occurs

Diabetic neuropathy slowly ensues from years of uncontrolled blood sugar levels that destroy the nerves. In some cases, smoking and alcohol abuse contribute to the development of neuropathy. Medical experts say a genetic disposition is to blame and sometimes the cause is totally unknown.

Management of Neuropathy

According to the Mayo clinic the goals in the management of neuropathy is to slow the progression of the condition, to relieve pain, manage other complications that may arise and to restore the function of the body area affected.

The best way to slow progression is to tighten control of your blood sugar levels. Monitor your blood sugar levels daily. Your blood sugar levels should be between 70- 130 mg/dl before meals and no less that 180 mg/dl two hours after meals. Undergo Hemoglobin A1C testing every three months and your values shouldn't be more than 7 percent.

Take your anti-diabetic medications as prescribed by your health care provider. Couple this with the right diet, exercise and healthy lifestyle habits.

To relieve pain, your doctor will recommend medications such as anti-seizure medication, anti-depressants, topical anesthetics or opioids which have been shown to work well.

Antispasmodics can ease incontinence. Consuming smaller but frequent meals can alleviate digestive problems. The incidence of low blood pressure on standing can be avoided by standing up slowly and drinking extra fluids.

Medications can restore functions of organs such as in erectile dysfunction. When they aren't effective men can resort to vacuuming. In women, lubrications can help.

Alternative Treatment

Alternative treatments work well too such as transcutaneous electrical nerve stimulation, acupuncture and biofeedback. Alternative treatments such as food supplements can complement medications. Clinical studies had proven that they can help in alleviating symptoms and slowing the progress of neuropathy. Alpha lipioc acid, evening primrose oil, acetyl L-carnitine, B complex vitamins, quercetin, bromelain, capsaicin and black currant seed oil are some of them.

The best way to prevent diabetic neuropathy is to maintain normal blood glucose levels daily. Continue your diabetic medications or insulin as instructed by your doctor, pay attention to your diet, weave in exercise in your daily routine and maintain healthy lifestyle habits.

A B Stephens is a chemical engineer by profession. Her passion to help diabetics stems from the fact that members of her family and her husband's family are diabetics. They launched http://www.typefreediabetes.com in 2007 - a one-stop shop for people who have diabetes - a lifestyle store complete with whatever a diabetic would need to live his/her life to the fullest! Nutritional supplements have been shown through clinical studies that they can complement medications in managing diabetic neuropathy. http://www.typefreediabetes.com/Diabetic-Neuropathy-Supplements-s/11556.htm

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The Different Types of Peripheral Neuropathy

Peripheral neuropathy affects millions of Americans every year. There are three different types of peripheral neuropathy, and they differ significantly both in the numbers of people afflicted and the severity of each different type.

The first type of peripheral neuropathy and the most common type is termed a polyneuropathy. This is most commonly caused by diabetes. The effect is on multiple nerves in the peripheral extremities, potentially including the feet, along with the hands. The nerves in the extremities with diabetes become affected to a varying extent, and a patient may end up having numbness, tingling, pins and needles, or severe pain. The extent of the pain may be different from one extremity to another, and may simply affect the lower extremities and not the hands.

It's not always diabetes that causes a polyneuropathy; it may be of use of drugs like alcohol, heavy metal toxicity such as with lead, utilization of drugs for cancer or infectious diseases, and a multitude of other disorders that can lead to polyneuropathy. At times, the cause is unknown, and this is called idiopathic.

The second type of peripheral neuropathy is called a mononeuropathy. A good example of a mononeuropathy would be carpal tunnel syndrome. The carpal tunnel syndrome involves compression of one peripheral nerve, that being the median nerve. It is extremely common condition and affects people in varying severity. It may be that it's a minor nuisance, and others may be bothered so badly by it that they need a carpal tunnel release surgery in order to stop the numbness, pain, and tingling. There are a multitude of other conditions where peripheral nerves by themselves are compressed, such as cubital tunnel syndrome or tarsal tunnel syndrome in the foot. The severity of the mononeuropathy may wax and wane, and steroid injections can help decrease the symptoms nicely in order to avoid surgery.

The third type of peripheral neuropathy is called mononeuritis multiplex. This disorder is a fairly complicated, painful condition involving at least 2 separate nerve areas. It is actually a group of disorders that is associated with disorders such as diabetes, rheumatoid arthritis, vasculitis, amyloidosis, Lyme disease, and potentially numerous other conditions. The incidence of mononeuritis multiplex in the US is actually unknown.

When it comes to treatment for the condition, the main factor is whether or not the underlying disorder can be figured out. If so, and be corrected, the neuropathy symptoms may somewhat abate. Or they might not, in which case there are various medications that can stem the tide of pain.

David L. Greene, MD, Phoenix, AZ is CEO of Preferred Pain Center which serves the Phoenix and Scottsdale, AZ metropolitan and surrounding areas. He can be reached at dgreene@preferredpaincenter.com and (602) 507-6550.

Preferred Pain Center is a Comprehensive Arizona Pain Management Center including Medical and Interventional Pain Management, Chiropractor Scottsdale Treatment, Physical Therapy, Spinal Decompression Therapy, and Manipulation Under Anesthesia.

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