Diabetic neuropathy (or the pathology of diabetic neuropathy) and diabetic pain can seem mysterious and complicated to understand to anyone who is first introduced to these terms.   They are particularly hard to understand for anyone with little previous knowledge of the nervous system.  You may be presenting to your doctor with a symptom such as a particular pain or loss of feeling in your feet and immediately your caregiver recognizes these as diabetic neuropathy symptoms; most likely you will be confronted with several medical terms that you have never heard of before.  No doubt, when a physician is talking way over our head it can be intimidating, as well as frustrating.   It seems that no matter what age we are, we (men and women alike) want to understand why we have a particular symptom and the best way to treat it.

For example, perhaps you have made a doctor’s visit due to pain and your physician immediately recognizes this as neuropathic pain and begins to explain neuropathy affects related to diabetes along with diabetic periphal neuropathy treatment.   Additionally, instead of hearing about your levels of glucose, they have expanded into talking about levels of sorbitol.  It can be overwhelming for patients to hear a barrage of new terms at one time or going from one subject to the other (like jumping from talking about blood to talking about a nerve).  When doctors introduce new words to patients like nitric oxide and glutathione it isn’t unusual for a person to leave the office with more questions than they went with or wondering later on what a certain term like “nerve conduction velocity” means or what something like a “serotonin reuptake inhibitor” is.  However, you needn’t feel intimidated by the terms used by medical professionals because even if you don’t understand the exact science behind them, the basic concepts (in laymen’s terms) can help ease your mind about painful peripheral neuropathy and other forms of neuropathies that you may suffer from.
Simply put, diabetic neuropathy refers to nerve disorders caused by diabetes whereas the pathology of diabetic neuropathy refers to the exact physiological aspects of the neuropathy.   Remember, it has taken years of formal study for your doctor to understand the pathology and researchers continue to study this subject.    Since 60 to 70 percent of people with diabetes form some type of neuropathy, it is wise to learn the symptoms, treatments and ways to prevent it.  However, it would be unfair for anyone (including yourself) to expect you to fully understand the pathology. Let’s break down nerve neuropathy a little more . . .

Diabetic neuropathy is actually divided into four groups:

1.    Peripheral neuropathy affects the arms, hands, legs, feet, and toes
2.    Autonomic neuropathy affects the blood vessels and heart, the digestive system, urinary tract, sex organs, eyes, sweat glands and lungs.
3.    Proximal neuropathy affects the hips, buttocks legs and thighs.
4.    Focal neuropathy affects the lower back and pelvis, abdomen, chest, thighs, legs, feet, eyes, ears and facial muscles.

As you can see, diabetic neuropathy affects the nerves throughout the body.  Because of this, there are several different types of symptoms that a neuropathy diabetic might encounter.  While pain, numbness, sensitivity to temperatures, sweating, etc. are noticeably identifying symptoms of neuropathy from diabetes, there are several other more subtle signs that you may miss.  This is why it is very important to inform your doctor of any physical changes you notice.

Neuropathy can manifest in such a wide range of ways that symptoms such as high blood pressure, constipation, sexual dysfunction, blurred vision, sweats etc. need to be assessed by a professional before they are diagnosed as or attributed to diabetic neuropathy.  In order to properly diagnose you doctor may order specialized tests such as nerve conduction studies to see how  well your nerves are transmitting and the surrounding muscles respond, ultrasound to look at various organs and they may check for variability of your heart rate (the hearts ability to respond to changes in posture and deep breathing). While undergoing tests can be scary keep in mind that the quicker you are diagnosed with (hypothetically lets say periphal neruopathies) the sooner you can begin peripheral neuropathy treatments that will leave you feeling better and able to do more. For most people, the thought of being neuropathy pain free is enough to not lose sleep over the tests.

Treatments for neuropathy are specific to the type of neuropathy.  Medications or physical therapy may be prescribed or you may be referred to a specialist for treatment of certain types of problems such as intestinal or heart disorders.  Among the many types of medications prescribed to relieve diabetic nerve pain are anticonvulsants, opioids and antidepressants. These neuropathy treatments will vary based on your individual case. It is important to note that these medications, (the antidepressants) are not being prescribed because your doctor thinks you are depressed but because the medications have been proven to help treat diabetic nerve pain and help ease the symptoms of periphal diabetic neuropathy.  This is also a good time to point out that many people who take anti-depressants refer to the reason as a chemical imbalance which is a common, simple term for the complicated physiological reasons for the medication.  Let your doctor worry about the pathology and deal with the terms like: nitric oxide and glutathione, levels of sorbital, and serotonin reuptake inhibitor.  You can better serve yourself by being mindful of ways you can help prevent periphal neuropathy diabetes and other forms of neuropathy.

People who smoke, are overweight, have been diabetic for more than 25 years or that have had frequent problems controlling their level of glucose are at the highest risk of developing diabetic neuropathy.  The best way to prevent diabetic neuropathy is to maintain your glucose level with proper eating, exercise and personal care.  Don’t smoke or drink alcohol.  Keep your doctor apprised of any changes to your health because it takes a doctor to decipher all the clues your body maybe giving that may lead to neuropathy diabetes.  When you do you may be able to nip the problem in the bud before it arises. Know that it should remain your priority to be watchful for changes diabetic neuropathy and to keep your glucose level on an even keel.