Diabetic neuropathy is considered a peripheral nervous system (PNS) disorder as opposed to a disorder of the central nervous system (CNS). While the central nervous system involves the brain and spinal cord, the peripheral nerve system includes the nerves that come from the spinal cord and innervates the rest of the body. Peripheral neuropathy can be caused by a number of different conditions, including: alcoholism, vitamin deficiency, autoimmune disease, certain medications, unknown causes, and diabetes. Pain, tingling and numbness can be produced when the peripheral nerves become damaged.
There are two main types of diabetes; type I and type II. Type I involves insulin (a hormone that controls blood sugar in a patient) dependence and type II which results from patients becoming resistant to their own insulin. Type I is commonly seen in children, possibly due to an immunological cause. Type II is most often seen in obese patients, who will be educated about the types of food that affect their blood sugar.
Exercise is an important step in reducing the symptoms of diabetes. A patient newly diagnosed with diabetes will likely be put on a regimen of diet, exercise and weight loss, which will hopefully eliminate the need for pharmacological medications. If diet and exercise alone don’t work, medication is the next step. Diabetics have a higher risk factor for cardiovascular disease, peripheral neuropathy, kidney disease, and retinopathy (affecting the eyes), and therefore must not be take their condition lightly.
When people do not have a strong control of their glucose levels, they will likely experience the complications associated with diabetes. Excessive sugar levels in the blood cause injury to the capillary walls that supply your nerves, especially in the hands and feet. The deterioration of the capillary walls can cause nerve damage which is usually first felt in the feet and moves towards the head. Erectile dysfunction is common in men without properly controlled diabetes, as the penile vessels are also damaged. Neuropathic gastrointestinal problems that accompany diabetes include nausea, vomiting, constipation or diarrhea, and a drop in blood pressure.
Diabetic peripheral neuropathy is not always easy to diagnose. A doctor will need to review a patient’s medical history, perform a physical examination and possible order imaging or lab tests in order to properly diagnose diabetic peripheral neuropathy. Often diabetic neuropathy diagnosis is based on excluding other possible disorders.
Treatment of diabetic peripheral neuropathy is even more difficult than diagnosing it. The ultimate goal is to stabilize and control the blood sugar levels which ultimately control the symptoms of diabetic peripheral neuropathy, but there are no quick fixes and a physician might suggest a number ways to treat a particular patient.
Membrane stabilizing medications tend to be the drug of choice among most doctors for treating painful neuropathies. These drugs, which include Cymbalta, Lyrica, Tramadol, Elavil and Neurontin, tend to “calm down” irritated nerves. Although these medications can help with pain symptoms, they do not prevent progression of the disease. NSAIDs and Opiates are also used for pain control without addressing the underlying problem. When other conservative methods fail, a physician will often suggest nerves blocks and/or Spinal Cord Stimulation(SCS).