Diffuse
Diabetic Neuropathy
DIFFUSE PERIPHERAL NEUROPATHY
The most common type of peripheral neuropathy damages the nerves of the limbs, especially the feet. Nerves on both sides of the body are affected. Common symptoms of this kind of neuropathy are:
The damage to nerves often results in loss of reflexes and muscle weakness. The foot often becomes wider and shorter, the gait changes, and foot ulcers appear as pressure is put on parts of the foot that are less protected. Because of the loss of sensation, injuries may go unnoticed and often become infected. If ulcers or foot injuries are not treated in time, the infection may involve the bone and require amputation. However, problems caused by minor injuries can usually be controlled if they are caught in time. Avoiding foot injury by wearing well-fitted shoes and examining the feet daily can help prevent amputations
.
Diffuse Autonomic Neuropathy
Urination and Sexual Response
Digestion
Cardiovascular system
Hypoglycemia
Sweating
People with diabetes are also prone to developing compression neuropathies. The most common form of compression neuropathy is carpal tunnel syndrome. Asymptomatic carpal tunnel syndrome occurs in 20 to 30 percent of people with diabetes, and symptomatic carpal tunnel syndrome occurs in 6 to 11 percent. Numbness and tingling of the hand are the most common symptoms. Muscle weakness may also develop.
The
two categories of diffuse neuropathy are peripheral neuropathy affecting the
feet and hands and autonomic neuropathy affecting the internal organs.
DIFFUSE PERIPHERAL NEUROPATHY
The most common type of peripheral neuropathy damages the nerves of the limbs, especially the feet. Nerves on both sides of the body are affected. Common symptoms of this kind of neuropathy are:
- Numbness or
insensitivity to pain or temperature
- Tingling, burning,
or prickling
- Sharp pains or
cramps
- Extreme sensitivity
to touch, even light touch
- Loss of balance and
coordination
- These symptoms are
often worse at night
The damage to nerves often results in loss of reflexes and muscle weakness. The foot often becomes wider and shorter, the gait changes, and foot ulcers appear as pressure is put on parts of the foot that are less protected. Because of the loss of sensation, injuries may go unnoticed and often become infected. If ulcers or foot injuries are not treated in time, the infection may involve the bone and require amputation. However, problems caused by minor injuries can usually be controlled if they are caught in time. Avoiding foot injury by wearing well-fitted shoes and examining the feet daily can help prevent amputations
.
Diffuse Autonomic Neuropathy
Autonomic Neuropathy (also Called Visceral Neuropathy) is another form of
diffuse neuropathy. It affects the nerves that serve the heart and internal
organs and produces changes in many processes and systems as mentioned the followings:
Urination and Sexual Response
Autonomic
neuropathy most often affects the organs that control urination and sexual
function. Nerve damage can prevent the bladder from emptying completely, so
bacteria grow more easily in the urinary tract (bladder and kidneys). When the
nerves of the bladder are damaged, a person may have difficulty knowing when
the bladder is full or controlling it, resulting in urinary incontinence. The
nerve damage and circulatory problems of diabetes can also lead to a gradual loss
of sexual response in both men and women, although sex drive is unchanged. A
man may be unable to have erections or may reach sexual climax without
ejaculating normally.
Digestion
Autonomic
neuropathy can affect digestion. Nerve damage can cause the stomach to empty
too slowly, a disorder called gastric stasis. When the condition is severe
(gastroparesis), a person can have persistent nausea and vomiting, bloating,
and loss of appetite. Blood glucose levels tend to fluctuate greatly with this
condition. If nerves in the esophagus are involved, swallowing may be
difficult. Nerve damage to the bowels can cause constipation or frequent
diarrhea, especially at night. Problems with the digestive system often lead to
weight loss.
Cardiovascular system
Autonomic
neuropathy can affect the cardiovascular system, which controls the circulation
of blood throughout the body. Damage to this system interferes with the nerve
impulses from various parts of the body that signal the need for blood and
regulate blood pressure and heart rate. As a result, blood pressure may drop
sharply after sitting or standing, causing a person to feel dizzy or
light-headed, or even to faint (orthostatic hypotension). Neuropathy that
affects the cardiovascular system may also affect the perception of pain from
heart disease. People may not experience angina as a warning sign of heart
disease or may suffer painless heart attacks. It may also raise the risk of a
heart attack during general anesthesia.
Hypoglycemia
Autonomic
neuropathy can hinder the body's normal response to low blood sugar or
hypoglycemia, which makes it difficult to recognize and treat an insulin
reaction.
Sweating
Autonomic
neuropathy can affect the nerves that control sweating. Sometimes, nerve damage
interferes with the activity of the sweat glands, making it difficult for the
body to regulate its temperature. Other times, the result can be profuse
sweating at night or while eating (gustatory sweating).
Focal Neuropathy
Focal Neuropathy (Including Multiplex Neuropathy) is diabetic
neuropathy that occasionally appears at a sudden and affects specific nerves,
most often in the torso, leg, or head. Focal neuropathy may cause:
- Pain in the front of
a thigh
- Severe pain in the
lower back or pelvis
- Pain in the chest,
stomach, or flank
- Chest or abdominal
pain sometimes mistaken for angina, heart attack, or appendicitis
- Aching behind an eye
- Inability to focus
the eye
- Double vision
- Paralysis on one
side of the face (Bell's palsy)
- Problems with
hearing
This
kind of neuropathy is unpredictable and occurs most often in older people who
have mild diabetes. Although focal neuropathy can be painful, it tends to
improve by itself after a period of weeks or months without causing long-term
damage.
Compression Neuropathy
People with diabetes are also prone to developing compression neuropathies. The most common form of compression neuropathy is carpal tunnel syndrome. Asymptomatic carpal tunnel syndrome occurs in 20 to 30 percent of people with diabetes, and symptomatic carpal tunnel syndrome occurs in 6 to 11 percent. Numbness and tingling of the hand are the most common symptoms. Muscle weakness may also develop.