Diabetic neuropathy is a disorder in the nerves, usually seen as a complication in
diabetic patients. It is often characterized by numbness and painful tingling
sensations in the extremities, such as the hands and feet, arms and legs.
Diabetic neuropathy may also lead to complications of the heart, reproductive
organs, and the gastro-intestinal tract, having symptoms such as indigestion,
loose bowel movement or diarrhea, constipation, vertigo, bladder problems and
even impotence. In severe cases, it can cause sudden weakness and abnormal loss
of weight, leading to depression. There are several treatments available
although usually to ease the symptoms exhibited and not really to cure the
underlying cause, which is diabetes.
Diabetic neuropathy symptoms vary. It starts with the loss of feeling in the
feet and sometimes a warm feeling followed by painful tingling sensations on the
toes and feet. Some do not feel any signs of neuropathy at the start but when it
becomes more severe, and then it suddenly exhibits itself. Unfortunately, since
the symptoms are unnoticeable at first, it is usually too late to undergo
treatment when it is finally detected. Diabetic patients are advised to avoid
any injury or wound on their body as well as regularly inspect their hands, feet
and legs for any lesion. This is because any injury to the extremities may not
be felt because of the neuropathy and end up in infection and even gangrene if
not treated early.
Extensive research has shown that these neurological symptoms are caused by a
prolonged elevation of glucose levels in the blood. Too much glucose can damage
the peripheral nerves in the body, leading to a loss of sensation and the
inability to send and receive signals. It can also lead to the damage of blood
vessels, especially the capillaries, blocking the supply of oxygen and nutrients
to some parts of the body. If this happens, the cells of that part of the body,
usually the feet, will die and usually lead to infection and gangrene. Some
patients are also genetically predisposed to having nerve diseases as compared
to others.
The precise pathway of how blood glucose damages the nerves is still highly
debatable. It is hypothesized that when the levels of blood sugar are high,
glucose is broken down into sorbitol, a glucose alcohol, instead of its normal
pathway of becoming carbon dioxide and water. Sorbitol is thought to compete
with myo-inositol, a substance responsible for the chemical structure of nerves,
in the maintenance of nerves, leading to its destruction.
Diabetic patients are very susceptible to having nerve problems especially if
they are having a hard time maintaining their blood glucose levels within normal
limits. Clinical neuropathies usually appear within the first years following a
positive diagnosis for diabetes. The risk increases as the diabetes continues.
In fact, diabetic neuropathy is one of the common diabetes complication seen in at least
seventy percent of people having diabetes.
Several risk factors also contribute in the early development of diabetic
neuropathies. Among these risk factors are smoking, problems with controlling
levels of blood glucose, and being over the age of forty. Studies are being made
on the effect of elevated glucose levels on nitrous oxide and proteins found in
the blood vessels. Nitrous oxide is responsible for blood vessel dilatation. An
excess of glucose over a long period of time may cause nitrous oxide to
decrease, thus constricting the blood vessels that supply the nerves and leading
to its damage. Also, when blood glucose is increased, it supposedly attaches
itself to the circulating lipoproteins, alters its function and structure to
affect blood circulation. But there is still a lot of ongoing research about
these pathways and as to finding what really causes neuropathies to happen in
diabetes.
