Diabetic Neuropathy, also known as diabetic nerve damage, is a common complication of diabetes that occurs when high blood sugar levels damage nerves over many years. The damage disrupts the messages sent to and from the nervous system and the rest of the body. There are many types of diabetic neuropathy but they all occur because of damage to nerves caused by diabetes. The symptoms can range from tingling and numbness to burning pain or total loss of sensation.
Risk Factors for Developing Neuropathy
Some of the main risk factors for developing diabetic neuropathy include:
- Duration of diabetes: The longer a person has diabetes, the higher their risk. Risk increases significantly after 10-15 years of living with diabetes.
- Poor blood sugar control: When blood sugar levels are not well managed over many years, it causes nerve damage which leads to U.S.Diabetic Neurotherapy. The risk is higher if HbA1c levels are consistently above 7.5%.
- Obesity: Being overweight increases inflammatory processes and metabolic changes which put additional stress on nerves.
- High blood pressure: Poorly controlled blood pressure, especially systolic pressure above 140 mm Hg, accelerates nerve damage.
- High cholesterol: Elevated LDL ("bad") cholesterol levels worsen neuropathy by narrowing small blood vessels which nerves rely on for proper functioning.
- Family history: Genetics plays a role and those with a parent or sibling who had nerve damage due to diabetes are at increased risk themselves.
Types of Neuropathy
The main types include:
- Peripheral neuropathy: Damage to nerves outside of the brain and spinal cord. Numbness and pain in hands and feet are common.
- Autonomic neuropathy: Problems with automatic body functions from damage to nerves in organs. Can cause gastrointestinal, genitourinary, or cardiovascular issues.
- Focal neuropathy: A single nerve is injured such as a cranial nerve affecting facial muscles or eye motion.
- Proximal neuropathy: Rare type where large nerves in arms and legs are predominantly damaged.
Neuropathy Symptoms
Symptoms differ depending on the type but may include:
- Numbness or reduced ability to feel pain or temperature changes especially in feet.
- Burning or tingling pain, especially at night.
- Sharp, jabbing, or electric-like sudden pains.
- Muscle weakness.
- Constipation, diarrhea, problems emptying bladder.
- Erectile dysfunction or inability to have an orgasm.
- Foot ulcers or cuts that do not heal properly.
- Autonomic issues like rapid heartbeat, low blood pressure.
Diagnosing Neuropathy
Doctors diagnose neuropathy based on a review of symptoms, physical exam, and sometimes additional tests. The most important tool is the monofilament test where a thin nylon wisp is applied to different areas of the feet to check sensation. Vibration testing with a tuning fork placed on feet/legs also evaluates sensibility changes. Electromyography measures electrical activity in muscles and nerves signal speed.
Treating Neuropathy
The main approaches to treatment are:
- Blood sugar control: Keeping glucose levels as close to normal as possible is key to prevent further damage and possibility of improvement.
- Medication: Various oral drugs may provide relief of nerve pain including gabapentin, pregabalin, duloxetine. Topical creams with lidocaine may also be used.
- Nutritional supplements: Alpha-lipoic acid and benfotiamine supplements may aid neuropathic symptoms.
- Physical/Occupational therapy: Specialized stretching, strength training and gait therapies help manage mobility issues.
- Alternative therapies: Acupuncture or transcutaneous electrical nerve stimulation are options some benefit from.
- Podiatry care: Daily foot checks for injuries, nail clipping, and Proper shoes/socks reduce risk of foot complications.
- Surgery: Sympathectomy is rarely used but cuts pain signals for severe cases not responding to other options.
Neuropathy management involves a multidisciplinary team including doctors, nurses, dietitians, physio/OT and ensuring proper self-care and protective behaviors minimize harms. Improving glucose control is one of the best preventative measures. Following treatment guidelines closely can make a real difference in neuropathy symptoms and quality of life for those living with diabetes.
The Growing Challenge of Diabetic Neuropathy in America
Rising Rates of Neuropathy Cases
According to the CDC, over 34 million Americans currently have diabetes. As diabetes prevalence continues increasing at concerning rates, so too does diabetic neuropathy. It is estimated that up to 70% of diabetic individuals develop some form of nerve damage over their lifetime. The earlier age of diabetes onset means neuropathy now affects more working-age adults. Additionally, longer life expectancies mean people live with both conditions for decades accumulating complications. Data from insurance claims shows a major increase in neuropathy diagnoses in recent years.
High Economic Burden
With no cure available, lifetime management of neuropathy results in substantial healthcare expenses. Direct medical costs for treating neuropathy and related issues in the U.S. exceeded $10 billion in 2020. Lost work and reduced productivity due to nerve damage result in an additional multi-billion-dollar economic burden each year too. Early work disability further intensifies costs over the long-run. With diabetes projected to affect over 50 million Americans by 2030, neuropathy costs will continue escalating rapidly without improved prevention and care strategies.
Widespread Impact on Quality of Life
The physical, emotional and social impacts of neuropathy should not be underestimated. Chronic nerve pain can greatly diminish quality of life and cause depression or anxiety. Reduced mobility and risk of foot complications like ulcers jeopardize independence. Many report having to quit jobs or cut back work hours due to impairment. Neuropathy disrupts sleep and ability to participate in usual activities. Caregiving demands often fall on family too. With limited treatment options currently available, finding new ways to support those dealing with these challenges remains crucial.
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