What is diabetic neuropathy?

Diabetic neuropathy is a complication of diabetes that affects the nerves.

The most common type of diabetic neuropathy affects the peripheral nerves. It is called peripheral neuropathy. The peripheral nerves are the ends of the nerves that go out from the spinal cord to the muscles, skin, internal organs, and glands. Peripheral neuropathy causes these sensory and motor nerves to not work properly.

Diabetic neuropathy can also affect the nerves that regulate unconscious vital functions, such as heart rate and digestion. These nerves make up the autonomic nervous system, and this type of problem is called autonomic neuropathy.

How does it occur?

Doctors do not yet fully understand how diabetes damages the nervous system.

What are the symptoms?

The symptoms of peripheral neuropathy include:

• numbness and loss of feeling (usually first in the feet or hands)
• slower reflexes
• pain varying from minor discomfort or tingling sensations in fingers and toes to more severe pain; pain is usually “pins and needle” like, but may be sharp or lightning-like, or deep aches that make sleep difficult, or it may sensitize the skin to even light touch
• weak muscles

The symptoms of autonomic neuropathy include:

• low blood pressure and dizziness when you rise quickly from sitting or lying down
• rapid or irregular heartbeats
• nausea or vomiting
• difficulty swallowing
• constipation and diarrhea

How is it treated?

First be sure to get an accurate diagnosis. While a diagnosis of diabetic neuropathy may have been made, in about half of patients there are other causes of the neuropathy. While there is no specific cure for neuropathy, there is much that can be done to treat it.

Preventing the neuropathy from getting worse, is priority one. Studies have shown that people who keep their blood sugar at a normal level, are much less likely to ever get worse. Certain nutritional supplements that have been shown to be of real benefit in many patients. These include B-Complex vitamins, G.L.A. (Gamma Linolenic Acid), Chromium Piconolate, Magnesium, and others.

Pain can almost always be well controlled through the use on non-narcotic medicines. Certain medicines including certain anti-seizure medicines, anti-depressant medicines, and certain other medications, have been found to nearly eliminate nerve pain, through the stabilizing effects they have on the nerve membrane (outer skin of the nerve) and on the nerve messaging system. Certain creams applied to the skin might also help pain during the night. Medications can be used to treat nausea, vomiting, and diarrhea.

Numbness in the hands and feet often improves with proper nutritional support and pain relief, but only occasionally does it become close to normal. Proper care and “Do’s and Don’t’s” are important to learn, to avoid burning or injuring the numb body parts.

How can I take care of myself?

Neuropathy worsens other diabetes-related complications. For example, if you have lost feeling in your feet and legs, you may not know you have an injury or infection until it develops into a bad sore. Inspect the skin on your feet and lower legs regularly. See your health care provider promptly for calluses, sores on the skin, or other potential problems so they can be treated properly.

How long will the effects last?

Because neuropathy is a complication of diabetes, the risk of neuropathy will continue as long as you have diabetes. If your diabetes is kept under control, however, the risk may be greatly reduced.

How can I help prevent diabetic neuropathy?

There are two aspects to prevention, to control the diabetes as much as one can, and to maintain a healthy general and nutritional state.

• Try to keep your level of blood sugar at a normal level
• Maintain a normal blood pressure and exercise regularly
• Stop smoking
• Limit the amount of alcohol you drink
• There are certain nutritional supplements that have been shown to be of benefit in many patients. These include B-Complex vitamins, GLA (Gamma Linolenic Acid), Chromium Piconolate, Magnesium, and others.

What type of medical specialist can help me treat my diabetic neuropathy?

Certain individual specialists in the specialty of Physical Medicine and Rehabilitation and in Neurology have the expertise needed to effectively diagnose and treat diabetic neuropathy. Unfortunately, there are many specialists who do not have much expertise.

Fortunately, in southeastern Michigan, there is a specialist medical group that has extensive expertise and experience in the successful diagnosis and treatment of diabetic neuropathy. David S. Weingarden, M.D. & Associates P.C. have been successfully treating many patients with diabetic neuropathy for over 10 years. Further information can be obtained by calling (586) 228-2882.