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Category: Metabolism
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createdon: 14 Jul 2017
updatedon: 03 Apr 2023

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Author: Khoa Tran
Published Jul 14, 2017
Updated Apr 03, 2023

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Diabetic Neuropathy

Etymology and Pronunciation

Diabetes  (dye-uh-BEE-teez)
diabainein - Greek for "to pass through". Word references increased frequency of urination.

Neuropathy (noo-RAH-puh-thee)
neuron - Greek for "nerve"
pathos - Greek for "disease"

History of Diabetic Neuropathy

Diabetic neuropathy is a type of nerve damage that can occur in people with diabetes. The history of diabetic neuropathy dates back to the early 19th century, when the association between diabetes and nerve damage was first recognized.

In 1848, a French physician named Claude Bernard discovered that the liver plays a role in regulating blood sugar levels. This discovery led to further research into diabetes and its complications.

In the early 20th century, physicians began to notice that people with diabetes often experienced numbness and tingling in their feet and legs, as well as other symptoms related to nerve damage. In the 1930s, the term "diabetic neuropathy" was coined to describe these symptoms.

Further research in the mid-20th century revealed that high blood sugar levels, which are a hallmark of diabetes, can damage the nerves throughout the body. This damage can lead to a range of symptoms, including numbness, tingling, and pain in the feet and legs, as well as problems with digestion, sexual function, and other bodily functions.

Modern Understanding of Diabetic Neuropathy

Diabetic neuropathy is a type of nerve damage that occurs as a result of high blood sugar levels in people with diabetes. It most commonly affects the nerves in the feet and legs, but can also affect the nerves in the hands and arms. Symptoms of diabetic neuropathy can include numbness, tingling, and burning sensations, as well as muscle weakness and difficulty with balance and coordination. Diabetic neuropathy can be diagnosed through a physical exam and a review of symptoms, as well as nerve function tests and other diagnostic tests. Management of diabetic neuropathy typically involves controlling blood sugar levels, as well as managing symptoms with medication and other therapies.

Causes of Diabetic Neuropathy

Diabetic neuropathy is caused by high blood sugar levels in people with diabetes. Over time, high levels of sugar in the blood can damage nerves throughout the body, but particularly those in the feet and hands. Here are some ways that high blood sugar can cause nerve damage:

- Glucose toxicity: When there is too much glucose in the blood, it can cause chemical changes in the nerves that can lead to damage and dysfunction.
- Reduced blood flow: High levels of sugar can cause blood vessels to narrow, which can reduce blood flow to the nerves and damage them.
- Inflammation: High levels of sugar can cause inflammation in the nerves, which can lead to damage and dysfunction.
- Advanced glycation end products (AGEs): These are compounds that form when sugar reacts with proteins in the body. AGEs can accumulate in nerve tissue and contribute to nerve damage.

Other factors that can increase the risk of developing diabetic neuropathy include:

- Poorly controlled blood sugar levels: The longer you have had diabetes and the more poorly controlled your blood sugar levels are, the higher your risk of developing neuropathy.
- High blood pressure: High blood pressure can contribute to nerve damage by reducing blood flow to the nerves.
- High cholesterol levels: High levels of cholesterol can contribute to nerve damage by narrowing blood vessels and reducing blood flow.
- Smoking: Smoking can damage blood vessels and contribute to nerve damage.
- Alcohol use: Drinking too much alcohol can damage nerves and worsen existing nerve damage.

Treatments for Diabetic Neuropathy

The treatment for diabetic neuropathy focuses on managing symptoms and preventing further nerve damage. Here are some of the treatment options available:

- Blood sugar control: The primary goal of treating diabetic neuropathy is to control blood sugar levels. This may involve lifestyle changes, such as dietary modifications and regular exercise, or medication, such as insulin or oral diabetes medications.
- Pain management: Pain is a common symptom of diabetic neuropathy and can be treated with medication, such as over-the-counter pain relievers, prescription pain medication, or topical treatments like capsaicin cream.
- Antidepressants: Certain types of antidepressants can be used to treat neuropathic pain by altering brain chemistry and reducing pain signals.
- Anticonvulsants: Certain anticonvulsant medications can also be effective in treating neuropathic pain by reducing abnormal electrical activity in the nerves.
- Physical therapy: Exercise and physical therapy can help to improve muscle strength and mobility and reduce pain.
- Transcutaneous electrical nerve stimulation (TENS): This is a non-invasive therapy that involves placing electrodes on the skin to deliver low-level electrical currents to the affected area. TENS may help to reduce pain and improve nerve function.
- Alternative therapies: Some people with diabetic neuropathy find relief through alternative therapies such as acupuncture or massage.

It's important to work closely with your healthcare provider to determine the most appropriate treatment plan for your individual needs. In addition to treatment, managing diabetes through healthy lifestyle choices such as a balanced diet and regular exercise can help to prevent or delay the onset of diabetic neuropathy.

Symptoms

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Tingling, numbness, or burning sensations in the hands or feet (often beginning at the toes or fingers)
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Loss of sensation or hypersensitivity to touch or pressure
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Difficulty with coordination and balance
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Sharp or shooting pains, cramps, or muscle weakness
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Difficulty with coordination and balance
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Sexual dysfunction, such as erectile dysfunction or vaginal dryness
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Vision changes or difficulty with eye movement
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Need to urinate/pee frequently
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Difficulty urinating/peeing
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Muscle Weakness
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Nausea
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Vomiting
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Diarrhea

Confirmation Tests

- Physical examination
- Neurological exam
- Nerve conduction test
- Electromyography (EMG)
- Skin biopsy

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