Everything you need to know about diabetic neuropathy

What is diabetic neuropathy?

Diabetic neuropathy is any involvement of the nerves in someone with diabetes, where the cause cannot be attributed to any other reason.

Essentially diabetic neuropathy often is a diagnosis of exclusion.

It is the most common form of neuropathy worldwide, except for in certain countries where alcohol-related neuropathy is predominant.

Any nerve can be affected by the impact of diabetes so it can present in many different ways.

What are the different types of diabetic neuropathy?

The diiferent types of diabetic neuropathy depend on the nerves involved.

Typically diabetic neuropathy affects the extremeties- this is the most common presentation.

Patients get a stocking type neuropathy which starts in the tips of the toes and progresses up almost like a stocking.

Additionally, the hands may also be affected. Patients can get what they typically used to call a glove and stocking involvment.

However, no nerve is safe from the impact of diabetes. Depending on where the nerves are involved, there can be different presentations of diabetic neuropathy.

What doctors call diabetic neuropathy however, is the classical stocking type neuropathy, which is the most common presentation.

This neuropathy increases the risk of getting diabetic foot ulcers, increases the risk of developing pain and of course can lead to other foot problems such as charcot arthropathy.

You can get neuropathy in different regions of the body. It can affect the nerves that run the heart and the nerves in the gut, therefore you get different presentations, depending on the region that is predominantly involved.

What are the warning signs of diabetic neuropathy?

In relation to the classical stocking type distal diabetic neuropathy, typically, many patients don’t experience any signs until it is quite advanced. Even for symptoms that people typically experience, these symptoms are delayed quite late into the nerve involvement.

Symtpoms include tingling, slight sensation differences, numbness and a sense of cramp.

Diabetic neuropathy does not present with severe weakness. Patients don’t present with the sudden loss of ability to walk.

Even in extensive diabetic neuropathy, the physical compenent, (which doctors call the motor compenent) isn´t the predominant feature. The predominant feature is the sensory component and a loss of sensation, a loss of a position sense. These are the more prominent signs of a diabetic neuropathy.