Diabetes, which affects 29 million people, has many complications, including diabetic neuropathy. It is a nerve disorder that can cause numbness, pain, extending problems and weakness.
Nerve problems can develop at any time, often occurring about 10 years after the diagnosis of diabetes. The longer the person has diabetes, the higher the risk of developing neuropathy.
Diabetic neuropathy is more common in diabetics more than 40 years old, those who have problems controlling their blood pressure and smokers. About 5 million people in the U.S. have diabetic neuropathy.
Like other neuromuscular problems, the symptoms vary. The first signs of diabetic neuropathy may be numbness and tingling in the feet. The same person may have pain and insensitivity to pain with neuropathy.
Usually symptoms begin slowly and may go unnoticed initially. In other cases, the onset can be sudden and severe, especially with focal neuropathy, which affects specific nerves often in the torso, leg or head. Focal neuropathy occurs most often in older people with mild diabetes. The symptoms for that may include severe pain, aching behind the eye or problems with the eyes or hearing or Bell’s palsy.
In diabetic neuropathy, the pain may feel like a burning sensation in the feet. It has also been described as a series of jolts down the lower extremities. Because the pain can be worse at night, diabetic neuropathy can affect sleep.
Neuropathy can be localized or generalized, depending on what nerves are affected. Nerve damage can also affect digestion, the cardiovascular system, blood sugar, sweating and sexual function.
In addition to physical and neurological examinations, the doctors may also run some screening tests, including one to check sensation in the feet, blood tests, nerve conduction studies, eletromyography, ultrasound and nerve biopsy.
The treatment for diabetic neuropathy is aimed at relieving discomfort and preventing further tissue damage.
Treatment begins with controlling blood-sugar levels and continues with medications to relieve the pain, burning or numbness. Analgesics or anti-inflammatory drugs may help, as well as antidepressants, nerve medications, pain killers and topical creams.
Other treatments may include electronic nerve stimulations, biofeedback, relaxation training, exercise, warm baths and massage.
Scientists continue to study how high blood glucose leads to nerve damage and how constriction of blood vessels supplying the nerve contributes to nerve damage.
Several new drugs are being tested to help prevent or reverse diabetic neuropathy.
Experimental drugs being considered are aimed at blocking the formation of substances that damage the nerves.
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