ASK A PHYSICAL THERAPIST
- 01 Feb - 07 Feb, 2025
Qs 1: Doctor my mother is 55 years old and is facing diabetic neuropathy, kindly guide.
Ans: Diabetic neuropathy is a common and serious complication of diabetes, characterized by damage to the peripheral nerves. This condition arises due to chronic exposure to high blood sugar levels and other metabolic disturbances associated with diabetes. It can affect various parts of the body, leading to a wide range of symptoms and impacting the quality of life of individuals.
Understanding Diabetic Neuropathy
Peripheral nerves are responsible for transmitting signals between the central nervous system (brain and spinal cord) and the rest of the body. Diabetic neuropathy occurs when these nerves become damaged due to prolonged exposure to high blood glucose levels, leading to dysfunction in nerve signaling. The condition can involve sensory, motor, and autonomic nerves, resulting in symptoms ranging from mild discomfort to severe disability.
Risk Factors for Diabetic Neuropathy
While anyone with diabetes can develop neuropathy, certain factors increase the risk:
Poor Blood Sugar Control
Chronically high blood sugar levels are the primary cause of nerve damage. Maintaining glycemic control can significantly reduce the risk.
High Blood Pressure (Hypertension)
Hypertension contributes to vascular damage, impairing blood flow to the nerves and accelerating neuropathy.
Smoking
Smoking exacerbates vascular and nerve damage by reducing blood circulation and increasing oxidative stress on nerves.
Age
Older individuals are at greater risk as aging naturally reduces the body’s ability to repair nerve damage.
Duration of Diabetes
The longer a person has diabetes, the higher their risk of developing neuropathy due to prolonged exposure to harmful metabolic factors.
Alcohol Consumption
Excessive alcohol intake can independently damage nerves and worsen diabetic neuropathy by increasing oxidative stress.
Tall Stature
Taller individuals are more prone to neuropathy due to the greater length of peripheral nerves, which makes them more vulnerable to damage.
Types of Diabetic Neuropathy
Diabetic neuropathy is not a single condition but encompasses several distinct forms, each affecting different nerves and presenting unique symptoms.
Distal Symmetric Polyneuropathy
The most common form, accounting for more than 50% of cases.
Typically starts in the feet and progresses symmetrically to the hands (a "stocking-and-glove" distribution).
This form predominantly affects sensory nerves, although motor and autonomic nerves can also be involved.
Asymmetrical or Focal Neuropathies
These are less common but can cause significant functional impairments. Examples include:
Carpal Tunnel Syndrome: Compression of the median nerve in the wrist, seen in 14–30% of individuals with diabetes.
Radiculopathies/Plexopathies: Nerve root or bundle damage, leading to localized pain and muscle weakness, often affecting the thighs, hips, or shoulders.
Cranial Neuropathies: Damage to cranial nerves, causing symptoms like facial weakness, double vision, or drooping eyelids.
Symptoms of Diabetic Neuropathy
The symptoms of diabetic neuropathy depend on the type and severity of nerve involvement:
Sensory Symptoms
Numbness or reduced sensation in the hands and feet, following a symmetrical "stocking-and-glove" distribution.
Tingling, burning, or a "pins and needles" sensation in the feet or hands.
Pain, which can be sharp, shooting, or throbbing, often worse at night.
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