Good day to you all. I’d like to get right back in to our discussion on neuropathies caused by diabetes. These I also know something about as I have and do experience a number of them already. This has been caused partly by going so many years undiagnosed, allowing the diabetes to run rampant through my body.
One type of neuropathy I deal with is peripheral neuropathy. My feet, as I said in my previous post, have shown signs of neuropathy since I was diagnosed. My hands have carpal tunnel syndrome and I have custom made casts for both. It is A-typical (not typical), and linked to the diabetes. I often don’t feel it when I have hurt myself. I do some light woodworking and most of my own home renovations and I must be very careful handling my power tools. Often I don’t know I have cut myself until I see the blood flowing. A dangerous thing to be sure.
I suffer several of the symptoms listed below. Numbness and insensitivity to pain I deal with daily. When a new area is going to go permanently numb, I will first feel tingling, burning and prickling in that area, sometimes for several months. Often through the day I have unexplained sharp pains and cramps. And loss of balance and coordination just to round things off and make life interesting.
Peripheral neuropathy is responsible for damage in the arms and legs. The lower extremities (feet and legs) are usually affected before the upper extremities (hands and arms). Often diabetics feel no symptoms. Regular diabetic appointments with your doctor are recommended because he may be able to detect signs of neuropathy that you can’t yet.
Symptoms of peripheral neuropathy include:
Muscle weakness and loss of reflexes can be caused by peripheral neuropathy. Loss of reflex at the ankle can change the way a person walks. Foot deformities, like hammertoes and the collapse of the mid-foot can result.
Having feet that are numb or have lost feeling makes it easy not to notice injuries.
For instance, a few days ago I sliced the bottom of my foot, on the ridge back of the toes. I barely felt it, even to walk on. Had I not immediately taken care of it I would run the risk of infection. The infection can then spread to the bone resulting in amputation. Not something anyone would want.
A few years ago I had a friend who was diabetic. He had an injury to his ankle and despite being under a doctor’s care infection set in. He has now had several amputations to that leg as the doctors attempt to get rid of the infection that had spread to the bone. Every time the infection has started once again in the stump.
Please take care of ANY injuries promptly and if there is ANY sign of infection get in to your doctor immediately. If you are diabetic don’t try to care for an infection yourself. Your immune system is weak and may need help to battle it. Even a very small cut, if it won’t heal, can cause a life and/or limb threatening infection.
Autonomic neuropathy affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels. Other internal organs can also be affected. Problems with digestion, respiratory function, urination, sexual response, and vision can result. One may not experience the warning symptoms of hypoglycemia because the system that restores blood glucose levels to normal after a hypoglycemic episode (low blood sugar) can be affected,
I know something about hypoglycemia unawareness. I used to have definite signs of having a “low”. Shaking, sweating, nausea, weakness, and palpitations. I only had to get below a 5 to start feeling the signs. Now I don’t feel them. I am nauseous much of the time to begin with, so I no longer have that signal to rely on. The symptoms don’t happen now till I am under a 4 and usually not till I am approaching a reading of 3.5 or less.
The heart and blood vessels are part of the cardiovascular system. This is the system that controls blood circulation. Autonomic neuropathy can affect this system as well. When the nerves are damaged in this system it interferes with the body’s ability to adjust blood pressure and heart rate. Blood pressure can drop sharply after sitting or standing, making one feel light-headed or even cause one to faint. Damage to the nerves that control heart rate can make your heart rate stay high instead of rising and falling. A normal part of body function and physical activity.
Nerve damage to the digestive system most commonly causes constipation. It can also cause the stomach to empty too slowly, a condition called gastroparesis. It can cause persistent nausea, vomiting, bloating, and loss of appetite. Something I suffer from. Because you cannot digest your food properly gastroperesis can cause your blood glucose to fluctuate wildly. Damage to the esophagus can make it difficult to swallow, and damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. A faulty digestive system can also cause weight loss.
Autonomic neuropathy often affects the organs that control urination and sexual function. The bladder cannot empty completely, which can allow bacteria to grow in the bladder and kidneys, causing urinary tract infections. When the nerves of the bladder are damaged, a person may be unable to sense when the bladder is full or control the muscles that release urine. Urinary incontinence, either partial or total, can be a result. Many of us, as we get older, experience some incontinence. Like dribbling when we laugh, etc. The neuropathy makes it worse, of course.
Autonomic neuropathy can also decrease sexual response, although the sex drive may not change. A man may not be able to get an erection or may climax without ejaculating normally. A woman may have difficulty with arousal, lubrication, or orgasm.
The nerves that control sweating can be affected by autonomic neuropathy too. Damage to the nerves can prevent the sweat glands from performing properly and the result is that the body cannot regulate it’s temperature properly. This damage can also cause profuse sweating at night or while eating. Something I go through on a regular basis, though in my case menopause is a factor as well.
Autonomic neuropathy can affect the eyes. The pupils become less responsive to changes in light. A person may not be able to see well when a light is turned on in a dark room because the eyes won’t adjust quickly to the change, or you could have trouble with your night vision while driving. It seems to me that my vision is not only affected when in a dark room, or for driving but, due to the fact I wear bi-focal lenses now, I have a hard time focusing or getting the correct distance from the page to use either the upper portion of my glasses, or the lower portion meant for reading. On my computer my head is at an awkward angle in order to see the screen. Often this causes eye strain, and neck strain resulting in headaches.
Proximal neuropathy, sometimes called diabetic amyotrophy, amongst other names too hard to understand, starts with pain in the thighs, hips, buttocks, or legs, normally on one side of the body and is more common in those with type 2 diabetes and in older adults with diabetes. It causes weakness in the legs and difficulty going from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The recovery period varies, depending on the type of nerve damage.
Focal neuropathy appears suddenly and affects specific nerves, most often in the head, torso, or leg.
It may cause an inability to focus, double vision, aching behind one eye, paralysis on one side of the face, (called Bell’s palsy), severe pain in the pelvis or lower back, pain in the front of a thigh, pain in the side, stomach or chest, pain on the outside of the shin or inside of the foot, chest or abdominal pain (sometimes mistaken for heart disease, a heart attack, or appendicitis.It happens mostly in older adult diabetics and is painful and unpredictable, though it does tend to improve on its own over weeks or months and no long-term damage is caused.
People with diabetes also tend to develop nerve compressions, (or entrapment syndromes). Of these the most common is carpal tunnel syndrome. Carpal tunnel syndrome is typified by numbness and tingling of the hand and occasionally muscle weakness or pain. Other nerves susceptible to entrapment can cause pain on the outside of the shin or the inside of the foot.
I think I have covered most of the effects and types of neuropathy so, at this point I would like to thank my readers for coming back. I hope you are finding the information valuable and I look forward to your comments. The next installment(s) will be addressing prevention, diagnoses and treatment of diabetic neuropathies.
Peripheral neuropathy is responsible for damage in the arms and legs. The lower extremities (feet and legs) are usually affected before the upper extremities (hands and arms). Often diabetics feel no symptoms. Regular diabetic appointments with your doctor are recommended because he may be able to detect signs of neuropathy that you can’t yet.
Symptoms of peripheral neuropathy include:
- numbness or insensitivity to pain or temperature
- a tingling, burning, or prickling sensation
- sharp pains or cramps
- extreme sensitivity to touch, even light touch
- loss of balance and coordination
- These symptoms are often worse at night
Muscle weakness and loss of reflexes can be caused by peripheral neuropathy. Loss of reflex at the ankle can change the way a person walks. Foot deformities, like hammertoes and the collapse of the mid-foot can result.
Having feet that are numb or have lost feeling makes it easy not to notice injuries.
For instance, a few days ago I sliced the bottom of my foot, on the ridge back of the toes. I barely felt it, even to walk on. Had I not immediately taken care of it I would run the risk of infection. The infection can then spread to the bone resulting in amputation. Not something anyone would want.
A few years ago I had a friend who was diabetic. He had an injury to his ankle and despite being under a doctor’s care infection set in. He has now had several amputations to that leg as the doctors attempt to get rid of the infection that had spread to the bone. Every time the infection has started once again in the stump.
Please take care of ANY injuries promptly and if there is ANY sign of infection get in to your doctor immediately. If you are diabetic don’t try to care for an infection yourself. Your immune system is weak and may need help to battle it. Even a very small cut, if it won’t heal, can cause a life and/or limb threatening infection.
Autonomic neuropathy affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels. Other internal organs can also be affected. Problems with digestion, respiratory function, urination, sexual response, and vision can result. One may not experience the warning symptoms of hypoglycemia because the system that restores blood glucose levels to normal after a hypoglycemic episode (low blood sugar) can be affected,
I know something about hypoglycemia unawareness. I used to have definite signs of having a “low”. Shaking, sweating, nausea, weakness, and palpitations. I only had to get below a 5 to start feeling the signs. Now I don’t feel them. I am nauseous much of the time to begin with, so I no longer have that signal to rely on. The symptoms don’t happen now till I am under a 4 and usually not till I am approaching a reading of 3.5 or less.
The heart and blood vessels are part of the cardiovascular system. This is the system that controls blood circulation. Autonomic neuropathy can affect this system as well. When the nerves are damaged in this system it interferes with the body’s ability to adjust blood pressure and heart rate. Blood pressure can drop sharply after sitting or standing, making one feel light-headed or even cause one to faint. Damage to the nerves that control heart rate can make your heart rate stay high instead of rising and falling. A normal part of body function and physical activity.
Nerve damage to the digestive system most commonly causes constipation. It can also cause the stomach to empty too slowly, a condition called gastroparesis. It can cause persistent nausea, vomiting, bloating, and loss of appetite. Something I suffer from. Because you cannot digest your food properly gastroperesis can cause your blood glucose to fluctuate wildly. Damage to the esophagus can make it difficult to swallow, and damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. A faulty digestive system can also cause weight loss.
Autonomic neuropathy often affects the organs that control urination and sexual function. The bladder cannot empty completely, which can allow bacteria to grow in the bladder and kidneys, causing urinary tract infections. When the nerves of the bladder are damaged, a person may be unable to sense when the bladder is full or control the muscles that release urine. Urinary incontinence, either partial or total, can be a result. Many of us, as we get older, experience some incontinence. Like dribbling when we laugh, etc. The neuropathy makes it worse, of course.
Autonomic neuropathy can also decrease sexual response, although the sex drive may not change. A man may not be able to get an erection or may climax without ejaculating normally. A woman may have difficulty with arousal, lubrication, or orgasm.
The nerves that control sweating can be affected by autonomic neuropathy too. Damage to the nerves can prevent the sweat glands from performing properly and the result is that the body cannot regulate it’s temperature properly. This damage can also cause profuse sweating at night or while eating. Something I go through on a regular basis, though in my case menopause is a factor as well.
Autonomic neuropathy can affect the eyes. The pupils become less responsive to changes in light. A person may not be able to see well when a light is turned on in a dark room because the eyes won’t adjust quickly to the change, or you could have trouble with your night vision while driving. It seems to me that my vision is not only affected when in a dark room, or for driving but, due to the fact I wear bi-focal lenses now, I have a hard time focusing or getting the correct distance from the page to use either the upper portion of my glasses, or the lower portion meant for reading. On my computer my head is at an awkward angle in order to see the screen. Often this causes eye strain, and neck strain resulting in headaches.
Proximal neuropathy, sometimes called diabetic amyotrophy, amongst other names too hard to understand, starts with pain in the thighs, hips, buttocks, or legs, normally on one side of the body and is more common in those with type 2 diabetes and in older adults with diabetes. It causes weakness in the legs and difficulty going from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The recovery period varies, depending on the type of nerve damage.
Focal neuropathy appears suddenly and affects specific nerves, most often in the head, torso, or leg.
It may cause an inability to focus, double vision, aching behind one eye, paralysis on one side of the face, (called Bell’s palsy), severe pain in the pelvis or lower back, pain in the front of a thigh, pain in the side, stomach or chest, pain on the outside of the shin or inside of the foot, chest or abdominal pain (sometimes mistaken for heart disease, a heart attack, or appendicitis.It happens mostly in older adult diabetics and is painful and unpredictable, though it does tend to improve on its own over weeks or months and no long-term damage is caused.
People with diabetes also tend to develop nerve compressions, (or entrapment syndromes). Of these the most common is carpal tunnel syndrome. Carpal tunnel syndrome is typified by numbness and tingling of the hand and occasionally muscle weakness or pain. Other nerves susceptible to entrapment can cause pain on the outside of the shin or the inside of the foot.
I think I have covered most of the effects and types of neuropathy so, at this point I would like to thank my readers for coming back. I hope you are finding the information valuable and I look forward to your comments. The next installment(s) will be addressing prevention, diagnoses and treatment of diabetic neuropathies.
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