The "neuro" part of neuropathy means that it is a nerve disorder. It is a fairly common complication of diabetes.

Neuropathy means that parts of the nerve system is damaged. One of the reasons for these damages are that the small blood vessels which normally provides oxygen and nutrition for the nerves are partially "plugged" which then means that the nerves will no longer function well. It is also known that the nerve cells can be damaged through high blood sugar levels (hypoglycemia). Glucose is normally transformed in the nerve cell into small amounts of sorbitol, which in turn is converted into fructose. In the case of hyperglycemia, a larger amount than normal of sorbitol is produced which will damage the cells because the next step - the conversion into fructose is then too slow due to the amount.

Diabetic neuropathy types

The most common type of diabetic neuropathy is called poly-neuropathy. It will affect the longest nerves first, these are the ones that reach all the way down to your feet. The symptoms are rather obscure at first, you may feel a certain numbness, maybe some tickling sensations on and off. This is similar to what people without the disorder can get at times. The difference here is that with neuropathy, the symptoms will eventually be stronger and longer lasting

It is difficult to diagnose a diabetes patient with this type of neuropathy at an early stage - but at the more advanced stages it is possible to test for less sensitivity for vibration and touching.

The Achilles reflex will also often be diminished or vanish totally. Some diabetics will have pain sensations in the feet, but it is more common to loose the ability to feel things so normal simple problems like scratching the foot on something can go unnoticed and there is a risk for infections.

People with neuropathy should pay special attention to the feet and inspect them regularly for damages to minimize the risk for further complications which could eventually lead to amputation

Damage to other (surface) nerves

Even though the typical diabetic neuropathy symptoms will start with the feet, it isn't always that way. There are many other nerves in our body with highly specialized functions which can be affected. Some other typical problems can be with the nerves controlling our eye movements. If for some reason one of these nerves become damaged, it is not uncommon with "double vision" due to the fact that both eyes are no longer perfectly synchronized in their movements. Often these damages can be temporary and when the blood vessel opens up again, the nerve can heal and the problem goes away. Similar problems - also often temporary - are known to affect the fingers, their movements and their sensitivity.

Damage to other (inner) nerves

There are also inner organs which are controlled by nerves - and they can also be affected. The heart is one of these organs and the heartbeat is controlled by nerves to around 70 per minute. With a nerve damage, this frequency can increase to the "natural" speed of the heart when no longer controlled - this speed is somewhere just under 100.

With a damage to the nerves controlling the heart, there is also a risk that a stroke will not manifest itself as pain but rather only like a difficulty to breathe and general weakness. This is unusual but it can be a serious problem due to the risk of mis-diagnosing a stroke.

Gastroparesis - delayed gastric emptying

When the nerves to the stomach gets damaged by neuropathy, your digestion system will not work normally. The nerve controlling how food moves in the digestive region is called the Vagus nerve. If this nerve is affected by neuropathy, the food movement slows down or could even stop. This disorder often affects people with type 1 diabetes or type 2 diabetes. When cooking for diabetes you need special considerations for your recipes if you have gastroparesis.

When food stays for too long in the stomach, you may suffer from a bacterial over-growth when the food ferments. There is also the risk bezoars being created. Bezoars are hardened solid masses of hardened food. These can be dangerous if they hinder the free passage of food further on to the small intestine.

As an added difficulty for diabetics - Gastroparesis can make it more difficult to control the blood glucose level. The reason is what with a delayed flow of food in the stomach, when it finally moves on to the small intestine, your glucose levels start rising. With this degree of unpredictability you may have problems controlling the blood glucose levels.

Neuropathy treatment - what is there?

Although a lot or research is till necessary, it is absolutely clear that by controlling the blood glucose level through a rigid diabetic diet, there risk of diabetic neuropathy can be kept lower.

The symptoms including pain and tickling sensations in the patient's feet can be treated with different medicines like Tryptizol/Saroten.