If you have patients who are living with diabetes, chances are you are no stranger to making diagnoses of neuropathy. While some patients (even those who do have nerve damage) might experience no symptoms at all, about 60 to 70 percent of diabetics experience pain, soreness, loss of sensation, tingling in the extremities, and even digestive problems—or other conditions related to organ complications—all symptoms of peripheral neuropathy. Diabetes is, in turn, one of the most common causes of neuropathy overall.
A patient’s risk of developing diabetes-related neuropathy actually increases with age and extenuating health considerations (such as being overweight), partially because patients who have problems with glucose control for extended periods of time—25 years or more—are more susceptible.
So, what causes a patient who has diabetes to develop neuropathic symptoms? Research is occasionally unclear on the subject, but it is generally agreed that exposure to high blood glucose (high blood sugar) has a negative effect on nerve condition. Of course, this is in addition to other conditions or lifestyle factors commonly associated with causing or exacerbating neuropathy, such as injury, metabolic inconsistencies, inherited traits, or substance abuse.
There are a few kinds of neuropathy associated with diabetes, the most common being peripheral neuropathy (this is the type usually referred to when people simply say “neuropathy;” but we’ll get to the other types in a moment). Peripheral neuropathy is characterized by pain, numbness, tingling, and loss of motor function, among other sensation-related symptoms. This type is written about extensively, and can greatly impact quality of life for its sufferers. Most treatments available to medical practitioners target peripheral neuropathy, so the good news is, there are plenty of ways for you to treat this type.
Focal and proximal neuropathy result in muscle weakness and pain, and typically target a specific nerve grouping. These types of neuropathy are commonly characterized by weakness in the legs, causing difficulty standing and walking. This type of neuropathy often accompanies peripheral neuropathy, so be on the lookout for patients who experience weakness alongside loss of sensation or soreness.
Autonomic neuropathy, as the name implies, causes changes in autonomic bodily functions. These include bowel and bladder functions, sexual responses, and digestion. Autonomic neuropathy can be life-threatening in extreme cases, as it also affects nerves that serve the heart, lungs, and eyes. Especially troubling to diabetic patients is the resulting condition of hypoglycemia unawareness, which can obliviate the symptoms most diabetics associate with low glucose.
It is recommended for any diabetic patients to receive at least an annual foot exam. If neuropathy has already been diagnosed, a patient’s feet should be examined much more frequently. Additional to diabetic amputation concerns, you should test your patient’s protective sensation by pricking their foot with a pin, or running monofilament across their skin. If your patient has lost protective sensation, he or she could be at risk to develop sores that might not heal properly, leading to infection. If you have any questions about the proper methods to use in examining diabetic patients for neuropathy, contact NeuropathyDR®. We can be sure you have the tools and knowledge you need!
For other types of neuropathy, properly-trained clinicians should perform a check of heart rate variability to detect how a patient’s heart rate changes in response to changes in blood pressure and posture. Ultrasound imaging is also useful to diagnose autonomic neuropathies and to ensure other internal organs such as the kidneys and bladder are functioning properly.
To control diabetic neuropathy, it is important to advise patients to maintain a tight blood sugar control and a healthy diet (this methodology is advisable for diabetics in general, of course). Even if a patient does not have symptoms of neuropathy, regular checkups are wise. NeuropathyDR® can train you to spot warning signs of factors that could endanger your patients’ nerve function or even be life-threatening. In addition, we can help you treat pain symptoms by providing valuable information about appropriate medications.
If your patients have diabetes, they are at risk! Don’t let neuropathic symptoms go unchecked. Remember, the sooner neuropathy is diagnosed, the easier it will be to treat and to slow the progression of this degenerative condition. NeuropathyDR® clinicians are trained to identify the various types of neuropathy and recommend the treatments that help their patients retain their quality of life. If you have any questions about treating patients who have or might have diabetic neuropathy, contact us!