The peripheral nerves have a function in conducting signals from the brain to the muscles as well as returning information from the skin such as sensations of touch, pain, temperature and position. Diabetic neuropathy is a complication of diabetes which leads to loss of some of these nerve functions. Many other organs such as the heart, blood vessels, sweat glands and gut are also supplied by a meshwork of nerves and the function of these organs may also be affected in diabetic neuropathy.
There are many causes of neuropathy other than diabetes mellitus. In diabetes it is accepted that poorly controlled blood glucose concentrations are responsible. The exact mechanism for this association is not very well understood though many theories exist. People with diabetes who smoke, drink alcohol or have poor glucose control seem to have more neuropathy than other people with diabetes.
Neuropathic pain can be intractable and disabling. Often these symptoms respond poorly to treatment and have a profound impact on quality of life. Some of the problems associated with long term painful neuropathy include:
The risk of developing diabetic neuropathy increases with:
For patients with painful neuropathy there are drug treatments available for pain relief including amitriptyline, carbamazepine and gabapentin.
Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospital Diabetes Service