What is diabetic neuropathy?
Diabetes mellitus and its associated misregulated blood sugar levels can cause a wide range of consequential damage that can affect practically all parts and systems of the body. A distinction is made between short and long-term secondary diseases. The latter include damage to nerves (neuropathy), which, taking into account its cause, is referred to as diabetic neuropathy.
About every third diabetes patient develops diabetic neuropathy in the course of the disease. If only a single nerve is affected, it is called diabetic mononeuropathy, if several nerves are damaged, it is called diabetic polyneuropathy. In most cases, the neuropathy affects so-called peripheral nerves, which are responsible for the movement of muscles and for conveying skin and sensory impressions. Diabetic autonomic neuropathy, on the other hand, is a special case in which internal organ or sensory functions are impaired (e.g. cardiac dysrhythmia, intestinal paralysis, bladder weakness or erectile dysfunction).
Associated symptoms of diabetic neuropathy
Diabetic neuropathy can manifest itself in many different ways, depending on which nerves are affected. Most often this occurs in the form of nerve-related sensations (“paresthesias”), which cause the affected person to feel tingling or burning sensations. Occasionally a so-called neuropathic pain also occurs.
This is usually described by those affected as an abrupt, shooting pain, often in combination with burning or tingling sensations. This pain often worsens at night and thus regularly robs the affected person of sleep. In rare cases, paralysis or numbness may also occur in individual muscles or skin areas.
Although theoretically there is a broad spectrum of possible symptoms of diabetic neuropathy, the disease often manifests itself in a certain pattern: the feet and legs are the first to be affected, where sensations of tingling and burning sensations are repeatedly experienced or a disturbed perception of cold and heat is noticed. Over time, recurring, shooting pains (neuropathic pain) are added and the symptoms spread to hands and arms. If no appropriate therapy is initiated even then, paralysis or numbness in the extremities may occur in the further course of the disease.
The reduced sensitivity of the skin of the feet and legs can also lead to a complicated secondary disease: the diabetic foot. This initially leads to a strange malpositioning of the foot. This is due to the fact that the weight is shifted in an unusual way in response to the damaged sensory nerves of the foot.
As the disease progresses, blisters, abrasions and other wounds develop without the patient being able to remember the cause. The reason for this is diabetic neuropathy: due to the reduction in skin sensitivity, the foot is less frequently shifted and weight is less frequently shifted to different parts of the foot. Thus, over a longer period of time, great pressure is exerted on the same part of the foot, which can lead to skin irritation and, over time, to open wounds. The symptoms of diabetic autonomic neuropathy must be considered independently of this. These include occasional heart palpitations or stumbling, reduced or increased sweating, diarrhea and constipation, regular feeling of fullness with belching and erectile dysfunction.
