When autonomic nerves are damaged, diminished ability to sweat or otherwise regulate body temperature can cause heat intolerance. Vision may blur, and falling blood pressure can cause fainting or dizziness. Other symptoms include:
- Diarrhea
- Constipation
- Abdominal bloating
- Feeling full after eating very little
- Nausea or vomiting after meals
- Unintentional weight loss
- Urinary hesitancy or incontinence
- A sense that the bladder doesn't fully empty
- Impotence
Symptoms of acute neuropathies begin suddenly and worsen rapidly. Damaged nerves heal slowly. Initial symptoms of chronic neuropathies are subtle. These conditions progress slowly and may remain unchanged for months or years. Symptoms may abate before they recur. Chronic neuropathies may worsen over time, but are rarely fatal.
Testing For Diabetic Neuropathy
The patient's history and symptoms and their suspected cause determine which diagnostic tests should be performed. Blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, and other metabolic or immune system abnormalities that may be the source of symptoms. Cerebrospinal fluid may contain neuropathy-related abnormalities, and neurologic tests can reveal abnormalities in movement, sensation, and organ function.
Electromyography (EMG) involves inserting a needle electrode through skin and into muscle. The electrical activity detected when the patient flexes the muscle indicates how the muscle responds to nerve stimulation. Results are displayed on a fluorescent screen.
A patient who has an EMG will probably also have nerve conduction velocity testing. This procedure measures nerve damage by the speed at which an impulse travels along a nerve. Surface electrodes placed on the skin above the nerve emit mild electrical stimulation. Other electrodes record the resulting activity.
Nerve biopsy involves removing a small amount of tissue from the lower leg or elsewhere for laboratory examination. This invasive procedure can yield important information about the extent of nerve damage. Nerve biopsy is difficult to perform. It may cause neuropathic side effects, and many physicians believe neuropathy can be diagnosed without it.
Easier to perform that nerve biopsy, skin biopsy has fewer side effects than the more invasive procedure. Skin biopsy removes a thin section of skin, which is examined for damage to small nerve fibers.
Treatments for Diabetic Neuropathy
The goal of treating diabetic neuropathy is to relieve discomfort and prevent further tissue damage. The first step is to bring blood sugar levels under control by diet and medication. Another important part of treatment involves taking special care of the feet. Analgesics, low doses of antidepressants, and some anticonvulsant medications may be prescribed for relief of pain, burning, or tingling. Some patients may find that walking regularly, taking warm baths, or using elastic stockings may help relieve leg pain.
Prognosis for Diabetics with Neuropathy
The prognosis for diabetic neuropathy depends largely on how well the underlying condition of diabetes is handled. Treating diabetes may halt progression and improve symptoms of the neuropathy, but recovery is slow. The painful sensations of diabetic neuropathy may become severe enough to cause depression in some patients.
Research on Neuropathy
The NINDS conducts and supports research on diabetic neuropathy to increase understanding of the disorder and find ways to prevent and cure it. New medications are currently being examined to assess improvement or stabilization of neuropathic symptoms.
The National Institute of Neurological Disorders and Stroke (NINDS) conducts and supports research on brain and nervous system disorders. NINDS is one of the more than two dozen research institutes and centers that comprise the National Institutes of Health (NIH).