Description Diabetic neuropathy...
Description
Diabetic neuropathy is a complication of diabetes that results in damage to the nerves in the body. It is a common complication caused by uncontrolled hyperglycemia (high blood sugar levels) for an extended period of time. It most often damages nerves in the lower legs and feet called peripheral neuropathy. It may also cause autonomic neuropathy (lightheadedness with standing, erectile dysfunction, incontinence, and difficulty emptying the stomach and bladder) and mononeuropathy (pain, weakness and/or numbness of a single nerve). The incidence increases with age and length of time with uncontrolled diabetes. It may occur in both Type I and Type II diabetics.
Symptoms
Symptoms vary depending on which nerves are affected. Peripheral neuropathy may cause numbness, tingling, burning, pain when walking, or increased sensitivity to light touch to the lower legs and feet. When the condition is more advanced, an individual may be at risk for development of skin ulcers, infections, and deformities. Autonomic neuropathy may cause lightheadedness with standing, incomplete bladder emptying, sexual function problems, and stomach and bowel problems. Symptoms of mononeuropathy (single nerve affected) depend on the nerve involved. For example it may cause vision changes, foot drop, or pain and weakness in an arm or leg.
Tests
Common tests used for diagnosis and treatment
Workup:
A complete history and physical will be performed. If you do not have a past medical history of diabetes, your provider will order blood sugar testing, which may include a random or fasting blood sugar and/or a hemoglobin A1C. Other specific tests may include EMG / Nerve conduction studies and a 2-point discrimination test.
Tests:
Electromyography (EMG), Hemoglobin A1c (HbA1c)
Other Specific Tests: Nerve biopsy, 2-point discrimination test
Specialists:
Internal Medicine, Family Practice, Diabetes, Endocrinology and Metabolism
Workup:
A complete history and physical will be performed. If you do not have a past medical history of diabetes, your provider will order blood sugar testing, which may include a random or fasting blood sugar and/or a hemoglobin A1C. Other specific tests may include EMG / Nerve conduction studies and a 2-point discrimination test.
Tests:
Electromyography (EMG), Hemoglobin A1c (HbA1c)
Other Specific Tests: Nerve biopsy, 2-point discrimination test
Specialists:
Internal Medicine, Family Practice, Diabetes, Endocrinology and Metabolism
Treatment
Treatment depends on the level of involvement and the nerves involved. Blood glucose levels should be controlled to help prevent further progression of the disease. Drugs used to reduce pain include tricyclic antidepressants, duloxetine (Cymbalta), pregabalin (Lyrica) and gabapentin (Neurontin). Foot care is essential to avoid ulcers and infection.