Diabetic neuropathies

"It is diagnosed by performing a nerve conduction velocity test".

DR. JAVIER ESCALADA
DIRECTOR. ENDOCRINOLOGY AND NUTRITION DEPARTMENT

The presence of inadequate levels of glucose in the blood and other factors that frequently occur in people with diabetes (high blood pressure, hypercholesterolemia ...) can alter the nerve fibers in any location resulting in a group of disorders that have specific characteristics according to the nerves affected and are collectively called diabetic neuropathies.

There are at least three main types: sensory-motor neuropathy (the most typical and frequent forms), autonomic neuropathy and mononeuropathy.

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What are the symptoms of diabetic neuropathy?

As with diabetes, the early stages of diabetic neuropathy are usually asymptomatic, even for years.

In the most common type of diabetic neuropathy, sensory-motor neuropathy, initial symptoms include loss of sensation, incorrect perception of tactile sensations and, in some cases, pain with minimal friction of the skin. This usually occurs in the feet and hands initially and more so at night.

Slow and heavy digestions or alterations of the intestinal rhythm (diarrhea and/or constipation) may occur. Sometimes, diabetic neuropathy affects the control of the cardiovascular system resulting in syncope or low blood pressure when standing up abruptly.

Diabetic mononeuropathies can affect any nerve in isolation, resulting in paralysis of one side of the face, alteration of eye movement, paralysis and/or pain in a particular anatomical area.

The most common symptoms are:

  • Loss of sensation in extremities.
  • Incorrect perception of friction on the skin.
  • Slow and heavy digestions.
  • Syncopes, low blood pressure.

Are you diagnosed with diabetes?

Remember that it is important to have regular check-ups with your endocrinologist

What are the causes of diabetic neuropathy?

Although the intimate mechanisms by which it is produced are not completely known, we know that the nerve fiber is structurally modified by the accumulation of substances derived from the metabolism of excess glucose, which conditions the loss of the normal coating of the nerve fibers: myelin.

The loss of this protective sheath means a delay in the ability of the nerve to transmit information. In addition to this direct mechanism, the vessels that irrigate the nerves can be obstructed by mechanisms common with other chronic complications of diabetes.

What is the prognosis of diabetic neuropathy?

Unfortunately, there is currently no specific treatment for diabetic neuropathy that prevents its appearance or reverses the alterations of the nerve fibers.

Pharmacological means (nerve growth factors and others) are currently being investigated and may be used in the coming years. There have been notable advances in the control of pain associated with some of these cases, which, on occasion, is of very high intensity and does not respond to usual measures.

Likewise, electronic systems of transcutaneous electrical nerve stimulation (TENS) can be placed that produce continuous electrical stimuli to the nervous system in a controlled manner, exceeding the capacity of the same to send painful information to the brain.

How is diabetic neuropathy diagnosed?

Imagen 3D de neuronas. Clínica Universidad de Navarra

When the doctor detects symptoms or signs of diabetic sensory-motor neuropathy, he or she can confirm this by performing a nerve conduction velocity test, which consists of determining the speed of transmission of small electrical currents through the nerves being studied.

For the study of affectation of other nerves (autonomic neuropathy or mononeuropathy) specific functional studies of the affected organs are necessary: heart, stomach...

How is diabetic neuropathy treated?

Early treatment is the best way to slow down the evolution

Diabetic neuropathy should be prevented or stabilized by controlling diabetes as strictly as possible.

In cases of painful diabetic neuropathy, which can sometimes produce severe and disabling pain, various analgesic treatments are used, often in combination: anti-inflammatory, anticonvulsant, local anesthetic...

In cases of painful neuropathy without response to these drugs, electronic transcutaneous electrical nerve stimulation (TENS) systems are used. By applying small currents in a programmed manner, these systems prevent the transmission of pain information by the affected nerve roots.

Where do we treat it?

IN NAVARRA AND MADRID

The Department of Endocrinology and Nutrition of the
of the Clínica Universidad de Navarra

The Department is organized into care units with specialists totally dedicated to the study, diagnosis and treatment of this type of disease.

We work with established protocols, which ensure that all diagnostic tests to be performed are done in the shortest time possible and that the most appropriate treatment is started as soon as possible in each case.

Organized in care units

  • Obesity Area.
  • Diabetes Unit.
  • Thyroid and Parathyroid Disease Unit.
  • Osteoporosis Unit
  • Other diseases: e.g. Cushing's syndrome.
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Why at the Clinica?

  • European Center of Excellence in the diagnosis and treatment of Obesity.
  • Team of specialized nurses at the Day Hospital of Endocrinology and Nutrition.
  • We have a Metabolic Research Laboratory of international prestige.

Our team of professionals

Safer than ever to continue taking care of you

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