Complications of Diabetes (Neuropathy) part 1

Well here I am again. I woke up this morning with my feet half asleep and slightly numb. Ah ha, I thought, here are my next several posts. The complications of diabetes.

These can be many and varied, including, but I think, not limited to :

• diabetic neuropathy: the nerve damage
  
• heart disease and stroke
• diabetic retinopathy (diabetic eye disease)
  
• erectile dysfunction
• hypoglycemia (low blood glucose)
  
• kidney disease and failure
• sexual and urological problems
• stomach nerve damage (gastroperisis)
  
• liver damage

There are several on the list that I now know something about. Like diabetic neuropathy.

When I was first diagnosed and attended my first diabetic clinic they tested my nerve feeling in my feet. First they had me look away and (I saw afterward) ran a feather around my feet. I couldn't feel it. A sign of some nerve problems already.

Next they poked my feet with something (a pin I think). This I could feel, indicating that the nerve damage wasn't too bad yet, but was definitely there.


Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs.

These symptoms depend on the type of neuropathy and which nerves are affected.

The first symptom is often numbness, tingling, or pain in the feet. This is often minor at first and because most nerve damage occurs over several years, mild cases may go undetected for a long time. However, for some people the onset of pain can be sudden and severe. Symptoms can involve the sensory, motor, and autonomic—or involuntary—nervous systems.

Symptoms of nerve damage may include:

• numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
• wasting of the muscles of the feet or hands
• indigestion, nausea, or vomiting
• diarrhea or constipation
• dizziness or faintness due to a drop in blood pressure after standing or sitting up
• problems with urination
• erectile dysfunction in men or vaginal dryness in women
• weakness

Though my muscles are not wasted, yet, I fight with just about everything on the list! Even as I write this my hands are fairly numb. My toes and half my feet are going numb off and on, depending on where I put them.


I don't have vomiting most of the time. I have constant nausea which I take another medication for. And acid reflux disease, a severe form of indigestion which I take yet another medication for. I have gone through several medications and developed a resistance to them so I have had to change every so often.

I experienced numbness, and tingling. My feet and hands go numb (what most would call "going to sleep") quite a bit, and on the side of my knee I had felt a tingling sensation, (somewhat itchy too when it tingled), for a long time. Now the area is just numb. At least on the surface. I can still feel a good poke in those areas though.

I have bouts of alternating diarrhea and constipation. The bouts of diarrhea are the worst. I can't go out of my home or be very far from a bathroom, which makes it difficult to work at times even though I only work part time, one or two days a week. When it hits, with absolutely NO warning, I need a bathroom NOW!!

If I am faced with a bout of constipation I only have problems when my system starts working again. Then I experience excruciating cramps and pain until I am able to relieve myself. Often I will go from constipation right into a bout of diarrhea. Not a whole lot of fun to say the least.

Everywhere I go, I scope out where the nearest bathrooms are. I don't go out and visit much anymore either because I find it embarrassing to be hit with a bout of diarrhea while visiting.

Is it any wonder that some fight with symptoms that are not due to neuropathy, but often accompany it, including weight loss and depression.

Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

Up to 70 percent of diabetics have some type of neuropathy. And it can develop at any time, though there is an increased risk the older you are and the longer you have had diabetes. The highest rates of neuropathy are amongst people who have had diabetes for at least 25 years.

Diabetic neuropathy also seems to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat, high blood pressure and those who are overweight. Many diabetics on insulin become overweight. A side effect of insulin is weight gain and it's a catch 22. The more weight you gain the more insulin you need, the more insulin you need, the more weight you gain.

The causes are probably different for different types of diabetic neuropathy. Nerve damage is likely due to a combination of factors:

• metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin
• neurovascular factors lead to damage of the blood vessels that carry oxygen and nutrients to nerves
• autoimmune factors cause inflammation in nerves
• mechanical injury to nerves, like carpal tunnel syndrome
• inherited traits that increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use

Classifications of diabetic neuropathy are peripheral, autonomic, proximal, or focal. Each affects different parts of the body in different ways.

• Peripheral neuropathy, the most common type, causes pain or loss of feeling in the toes, feet, legs, hands, and arms.
• Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual function and response, and perspiration and can affect the nerves that serve the heart and control blood pressure, nerves in the lungs and eyes. It can cause hypoglycemia unawareness as well, a condition in which people no longer have the warning symptoms of low blood glucose levels.
• Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs.
• Focal neuropathy is the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.

Peripheral neuropathy affects:

• toes
• feet
• legs
• hands
• arms

Autonomic neuropathy affects:

• heart and blood vessels
• the digestive system
• the urinary tract
• sex organs
• sweat glands
• eyes
• lungs

Proximal neuropathy affects:

• thighs
• hips
• buttocks
• legs

Focal neuropathy affects:

• eyes
• facial muscles
• ears
• pelvis and lower back
• chest
• abdomen
• thighs
• legs and feet

I think I will stop here for today. Tomorrow I will discuss the various types of neuropathy in a bit further depth. I hope this blog on diabetes is helpful to some, especially those newly diagnosed. Till my next post, God bless.