Diabetic Neuropathy refers to the complications of diabetes mellitus affecting the peripheral nerves, which mainly occur with sensitivity disorders, and often pain, in the parts of the body of the affected nerves, usually in the lower limbs starting from the feet. Almost half of diabetics have this side effect called neuropathy. All the nerves in the body can suffer from long elevated blood sugar levels, but the most vulnerable ones are the cranial and leg nerves. Alterations of vegetative functions are also frequent, especially in the cardiovascular field, while motor difficulties are only rarely present.
Diabetic neuropathy can occur in both type 1 and especially type 2 diabetes in over half of diabetic patients; the manifestations occur in increasing proportion, and with greater severity, in relation to the longer duration of diabetes, as well as poor metabolic control and advanced age. An involvement of the peripheral nervous system during prediabetes (reduced glucose tolerance) is also possible, especially in association with the so-called metabolic syndrome (excess abdominal fat, increased cholesterol and triglycerides, high blood pressure, as well as insulin resistance).
The pathogenesis of diabetic neuropathy is strictly dependent on hyperglycemia, which causes nerve fiber damage through complex mechanisms, attributable to two orders of factors: metabolic alterations and vascular impairment. The metabolic alterations lead to a deficit in the production of energy, necessary for the activity of the nerve fibers, especially as a consequence of oxidative stress; alterations of the vessels, especially arterioles and capillaries (microangiopathy), which supply the nerves with blood, thus causing ischemic damage due to reduced supply of oxygen to the nerve fibers. Metabolic and vascular factors influence each other, triggering a vicious circle responsible for the progressive course of diabetic neuropathy.
It should also be noted that in some less common subtypes of diabetic neuropathy, such as radicular plexus neuropathy, pathogenic factors of an inflammatory or autoimmune nature appear instead. Diabetic neuropathy can occur in various clinical forms which are classified, according to the nerves involved and the location of the manifestations, in diffuse symmetric (more frequent) forms, and asymmetrical focal or multifocal forms.
Why are legs so frequently affected? And why the legs and not the arms? The reason is simple: the nerves of the legs are the longest nerves in our entire body. The longer the nerve, the more vulnerable it is to the toxic action of high blood sugar. While for the cranial nerves it is the motor function that is mainly affected, from which the onset of paralysis, here it’s the sensory function that is mainly compromised, from which the loss of sensitivity or sensations of various types affecting the feet.
The neuropathic foot
Pain, an awful sensation it is also an awful emotional feeling. When physical pain becomes chronic the patient alerts and tries to find the reasons to respond. Usually the beginning is hardly felt. The sole of the foot, often one more than the other, becomes insensitive to the touch, to the sensations of pain and to the heat and cold: a little as if it were "dead". It is possible at this stage to injure the foot or leg or get burned without almost feeling the pain. When walking, you have the sensation of resting your foot on a carpet or on the grass. Soon from this state of reduced sensitivity we move on to painful sensations that usually start as tingling and rapid sensations of shock and end with more or less strong pains. Especially at night the pain becomes unbearable, often similar to a burn, so the diabetic seeks relief by placing his bare foot on the cold floor. This very annoying situation and sometimes so painful as to prevent sleep, can improve and sometimes regress with appropriate care and, above all, with the most scrupulous attention to blood sugar control. One can also experience more serious problems as infections, bone or joint pain or ulcer, sores that can result in the amputation of a toe or even the leg if the sores become infected or if they affect the bone.
The wounds are difficult to heal because of the uncontrolled blood sugar and nerve damage. Due to the fact that the peripheral nerves are damaged, the blood flow to feet and legs is reduced. The blood vessels or capillaries are also damaged and cannot supply the nerves with nutrients and oxygen.
Are these forms of diabetic neuropathy frequent? The pathogenesis of diabetic neuropathy is strictly dependent on hyperglycemia, which causes nerve fiber damage through complex mechanisms. Hypertension and hyperlipidemia are aggravating factors of neuropathy, and effective treatment of these risk factors is therefore important. Even if the most common cause of peripheral neuropathy is diabetes, neuropathy can also result from other causes.
Treatment for diabetic neuropathy
If you ask yourself how to cure of diabetic neuropathy or the methods of treatment, one thing is sure that there is no known,exact cure. The treatment implies relieving the pain and slowing down the evolution of the disease. Some clinical guidelines are measuring the level of glucose in the blood, the blood pressure and cholesterol. According to the Joslin Diabetes Center, controlling the blood sugar levels is the best way to prevent diabetic neuropathy and diminishes the nerve damage by over 50%.
Once you have high blood sugar levels, a doctor can usually prescribe a treatment including exercise and diet. If you follow this cure you can further reduce the risk of developing an illness such as diabetic neuropathy. The treatment may also include medication and other changes in one’s lifestyle management. After a thorough analysis of this disease I discovered a lot of alternative ways to ease neuropathy pain, such as, massage, plants, acupuncture, physical and chiropractic therapy. Other pain relief methods are creams, lidocain and calcium patches, antidepressants, but they can develop dependence and better to avoid, if possible. The latest method of cure which was published on 20 of May 2020 by Science News belongs to the researchers at the University of New Mexico who showed that legal Cannabis hemp oil diminished pain sensitivity 10 times for several hours. ( University of New Mexico. "Legal cannabis hemp oil effectively treats chronic neuropathic pain." ScienceDaily. ScienceDaily, 20 May 2020.)
This research was done on mice with chronic post-operative neuropathic pain. Hemp oil may be really analgesic, but, whether to believe or not in this investigation is up to every individual. However, this remains the latest medical investigation and discovery concerning diabetic neuropathy.