Diabetic Neuropathy
Dr. Leonel Porta
Written by Dr. Leonel Porta

Diabetic neuropathy (DN) is one of the most feared disorders caused by diabetes. Every other patient suffering from DN will show no symptoms. Therefore, chances are that these patients may not be aware they are suffering from this condition. What then can be done? How can anybody know for sure if they have DN?

In DiabeTV we have already discussed the different types of neuropathies, including the Peripheral Polyneuropathy (disease causing multiple damage to peripheral nerves), which is the most common neuropathy in diabetics. The most important preventive measure is to visit regularly your Doctor who can perform a series of simple clinical tests to detect symptoms suggestive of polyneuropathy. These signs include pain, reduced sensitivity to injuries, and numbness of the legs.

The clinical tests your doctor might recommend include:

  • Vibration threshold assessment by the tuning fork method.
  • Prick sensitivity.
  • Touch perception (using a10 g mono filament).
  • Achilles’ tendon reflex.

Sensitivity loss to the mono filament and a reduces threshold vibration can predict the appearance feet ulcers.

On the other hand, Autonomic Neuropathy results in many clinical manifestations such as: accelerated idle heart rate, exercise intolerance, orthostatic hypotension (low blood pressure when standing up), constipation, gastroparesis (malfunction of stomach movement and sensitivity of the stomach), erectile dysfunction, deterioration of the neurovascular function, and reduced autonomic response to hypoglycemia (low blood sugar). Additionally, this condition may have lead to other disorders such as:

  • Cardiovascular neuropathy: characterized by accelerated idle heart rate (more than 100 bpm) or orthostatic hypotension (drop in systolic blood pressure greater than 20 mmHg when patient stands up without an adequate cardiac response).
  • Gastrointestinal neuropathy: affects any sector of the digestive tract causing esophageal disease, gastroparesis (partial paralysis of the stomach), constipation, diarrhea, and fecal incontinence. Constipation is the most common symptom, but it can alternate with diarrhea outbursts.
  • Urinary tract neuropathy: recurrent urinary tract infections, incontinence or relaxed bladder.

If you feel any of these symptoms and suspect you may have Diabetic neuropathy now you know what to do. Consult your physician as soon as possible. It is important to consider other causes of neuropathy such as neurotoxic medications, heavy metal poisoning, alcohol abuse, vitamin B12 deficiency (particularly those taking metformin during prolonged period of time), kidney disease, inherited neuropathy, vasculitis, to name a few. Many of these neuropathies, including DN are treatable. An early diagnosis, however, is crucial. By doing so you have a great chance to get the best treatment that will guarantee you the quality of life you want and deserve!


About the author

Dr. Leonel Porta

Dr. Leonel Porta

Medical doctor and author of several publications. He has developed experience as a general practitioner and occupational health care, continually facing diabetes. His medical training and Jesuit values enable Leonel’s articles to seek not only physical, but also psychological, social and spiritual healing.