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Diabetic neuropathy

Diabetic neuropathy is a nerve disease caused by long-term elevated blood sugar levels in diabetes mellitus. Nerve fibers are damaged, which leads to different forms and manifestations. It is a frequent and sometimes very stressful complication of diabetes.

Origin and causes

When blood sugar levels are permanently high, certain metabolic products are deposited in the nerve fibers and the blood vessels that supply them. This damage leads to circulatory disorders, so that nerves are impaired in their function or die.

Forms and symptoms

1. Peripheral polyneuropathy

   • Affects mainly the long nerves in the feet and legs.
   • Typical signs are tingling, numbness, burning or pain in the feet.
   • Reduced sensation of pain and temperature increases the risk of injury or infection.

2. Autonomic neuropathy

   • Affects involuntary bodily functions, e.g. cardiovascular system, digestion, bladder function.
   • Possible consequences are cardiac arrhythmia, gastric emptying disorders (gastroparesis), erectile dysfunction, bladder emptying disorders or drops in blood pressure when standing up.

3. Mononeuropathy

   • Individual nerves are damaged, such as facial nerves or nerves in the arms and legs.
   • Can lead to sudden, localized symptoms of paralysis or sensory disturbances.

Diagnostics

• Medical history and clinical examination: doctor asks about complaints and checks reflexes, touch, vibration and temperature sensation.
• Nerve conduction velocity: Objective measurement to detect changes in the transmission of nerve signals.
• Blood tests: Checking blood sugar levels and other relevant parameters (e.g. vitamin B12 levels).

Treatment and management

1. Optimum blood sugar control
   • The most important measure to slow down or stop the progression of nerve damage.
2. Pain therapy
   • Use of special medication such as antidepressants (e.g. duloxetine), anticonvulsants (e.g. pregabalin) or other neuropathy-specific medication.
3. Foot care
   • Regular foot checks (e.g. by a podiatrist) to detect and treat injuries and infections at an early stage.
4. General lifestyle measures
   • Healthy, balanced diet and regular physical activity to stabilize the metabolism.
   • Avoidance of nicotine and excessive alcohol consumption, as both factors promote nerve and vascular damage.
5. Therapy of autonomic symptoms
   • Adjustment of fluid and salt intake in the event of a drop in blood pressure.
   • Treatment of stomach and bladder dysfunction with appropriate medication.

Prevention

If you regularly monitor your blood sugar, blood pressure and blood lipids, you significantly reduce the risk of diabetic neuropathy. Early detection and consistent treatment of diabetes helps to avoid long-term consequences.

Conclusion
Diabetic neuropathy is a potentially serious consequence of diabetes mellitus, but it can be positively influenced by good metabolic management and timely therapy. Regular medical check-ups, careful foot care and, if necessary, pain therapy measures are crucial to alleviate symptoms and prevent further damage.