Diabetes – There are Five Different Types of Neuropathy

Distal Symmetrical Polyneuropathy This type, also called simply polyneuropathy, involves the feet and legs and is usually described by the person as numbness or tingling in the feet. Sometimes a burning sensation is noted. Normalizing blood glucose levels is the best treatment at present.

There are several medications that can help this problem, although none will cure it. Of course, pain medications and narcotics will control the pain but have long-term problems. Anti-depressants are sometimes helpful as are some anti-seizure drugs such as Tegretol and Neurontin. Capsaicin, a derivative of peppers, in a cream form can sometimes be helpful in relieving the pain and burning but must be used carefully. Autonomic Neuropathy This type of neuropathy involves nerves that work without your needing to pay any attention to them-for example, nerves relating to the control of the blood pressure (orthostatic hypertension), to the stomach or gastrointestinal tract (possible problems include disease of the stomach [called gastroparesis] or the intestine [diabetic diarrhea]), to the sweat glands (loss of the ability to perspire), to the bladder (problems with urinating), to balance, and to sexual function. Autonomic neuropathy is not as closely associated with diabetes control as is peripheral neuropathy (neuropathy of the hands and feet), but diabetes control is still needed. There are a variety of other treatments that can control the results of autonomic neuropathy. Proximal Motor Neuropathy Also know as Diabetic Amyotrophy this type involves damage to the nerves in the muscle, resulting in weakness (also called diabetic amyotrophy) and shrinking of the muscle fibers. A burning sensation may also be experienced. The hands and thighs are most commonly affected, and the ankle joint may also be involved. Resolution or recovery may be experienced in 6 to 18 months. Cranial Mononeuropathy This type of neuropathy most often involves the eye muscles. Double vision may be present; the eyelids may droop, and the eyes may drain. Mononeuropathy may also involve the spine. Improvement in either of these is usually seen in 3 to 4 months. Radiculopathy This type begins at the roots of the spinal nerves. Pain or sensory loss may be experienced on any part of the skin surface. The most commonplace for radiculopathy is the nerves between the ribs. This causes very severe chest pain, especially with breathing. Sometimes it is so severe that the person needs oxygen because of the inability to get a deep breath. There is no treatment except supportive, but it is nonfatal and is self-limited. It will usually resolve within a week or two, though it can recur in the same nerve or in another nerve later. Recently, there has been documentation of improvement in the various forms of neuropathy with normalization of blood, glucose levels. This has given added support to the need to keep bloodFeature Articles, glucose values under 150 mg/dl (8 mmol) for the prevention of problems and for reversal of changes that may have already occurred.

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