Diabetic Peripheral Neuropathy

Written by PainDoctor.com Staff | 19 July 2010

Diabetic Peripheral Neuropathy is a disorder involving the peripheral nervous system (PNS). The central nervous system (CNS) includes your brain and spinal cord, and the PNS includes all of the nerves that come from your spinal cord and innervate the rest of your body.

Diabetic Peripheral Neuropathy can be caused by many conditions including vitamin deficiencies, alcoholism, autoimmune diseases, certain medications, unknown causes, and from diabetes. Damage to the peripheral nerves results in painful or tingling sensations, or numbness. An extremely common cause of peripheral neuropathy is diabetes.

The disease diabetes can be divided into Types I and II. Type I classifies those who are dependent on insulin, while Type II indicates those who are not. However, as time passes, a Type II patient may reach the point where they require insulin, but are still considered to be Type II. Type I is generally seen in children and adolescents and is thought to stem from possible immune system disorders. Type II is more often seen in obese patients, and is considered to be when they have become insulin resistant.

Those patients who do not closely monitor and adhere to caring for their diabetes will see more problems related to diabetes. Excess glucose (sugar) in a patient’s blood causes extreme damage, and can severely damage the capillary walls that are responsible for obtaining and delivering the blood the nerves need. Once the body has reached that point, the following symptoms may be seen:

• Numbness
• Tingling
• Pain
• Digital coldness (Raynaud’s phenomenon)
• Erectile dysfunction
• Gastroparesis (Nausea/ vomiting)
• Early satiety

While the symptoms may be indicative of Diabetic Peripheral Neuropathy, it still is a difficult diagnosis to make. Peripheral neuropathy can also be caused by a Vitamin B12 deficiency or thyroid disease, thus indicating that labs should be ordered to rule out any other possibilities. Once the diagnosis shows the patient to have Diabetic Peripheral Neuropathy, the treatment is often just as difficult as the making the diagnosis. In the case of peripheral neuropathy, the prevention of the disease is highly recommended, as the treatment is so difficult.

Should a patient be diagnosed with Diabetic Peripheral Neuropathy, the first order of treatment is usually exercise, a change of diet and weight loss. When one exercises, their muscles use sugar for energy, and so the body actually can use up the body’s store of sugar, causing the blood sugar level to decrease. By modifying the diet and including exercise, it may be possible to slow the effects of diabetes.

When diet and exercise have not been effective in controlling pain, medications are often the next course of action. Membrane stabilizing medications have shown to be effective in eradicating pain due to nerve irritation. These medications include Cymbalta®, Elavil®, Lyrica®, Tramadol® and Neurontin. Other pain relievers may help, but even if the pain is not present, these medications are not effective in slowing the progression of neuropathy.

Acupuncture, biofeedback and daily vitamin supplements have been shown to have success as well.

There are not many minimally-invasive procedures that can help those with diabetic peripheral neuropathy, but Spinal Cord Stimulation and steroid injections have been shown to make a difference.