Diabetic neuropathies describe a group of disorders that involves nerve damage caused by high blood glucose. Patients may not have symptoms, and those with symptoms usually complain of pain, tingling, and numbness. Diabetic neuropathy can occur in all organ systems, including the digestive tract, heart, and even sex organs. Although it may appear to be uncommon, 60-70% of diabetics have some form of diabetic neuropathy. The risk of neuropathy increases with age, long duration of diabetes, and particularly in individuals who have trouble controlling their blood glucose, blood pressure, and also people who are overweight or obese.

The American Diabetes Association (ADA) has recently released an update on diabetic neuropathies. The last update was in 2005, and since then, researchers manage to dig up more information and evidence. Their discoveries are shared in this latest update.

Prevention

In the recent guidelines by the ADA, the scientific community agrees that prevention is the most effective role in diabetic neuropathy. Similarly, screening plays a vital role in detection and intervention of diabetic neuropathy. Glucose control should also be optimized as soon as possible so that diabetic neuropathy can either be delayed or prevented in patients.

Distal Symmetric Polyneuropathy (DSPN)

Approximately 75% of diabetic neuropathy cases are DSPN cases. DSPN related cases account for a major cause of foot ulcers and are, therefore, big contributors to Charcot neuropathy, increasing the risk of amputation and mortality. Of course, this condition also contributes to falls and fractures.

Diabetic Autonomic Neuropathies

At least 30% of type 1 diabetics and up to 60% of type 2 diabetics have cardiovascular autonomic neuropathy after a duration of 15 years. Diabetic autonomic neuropathies are risk factors for mortality and other types of cardiovascular dysfunction. Patients with diabetes should be screened for cardiovascular autonomic neuropathy.

There are also other types of diabetic neuropathy. Doctors should stay vigilant and try to detect and treat all neuropathies, including those that are less common such as gastrointestinal (gut) and urogenital (urinary system) neuropathies. The update also states that there will be continuous efforts in finding ways to reverse this complication to improve the quality of life for patients.

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Rodriguez T. Diabetic Neuropathy: Updated ADA Position Statement. Feb 2017.   Accessed 2/28/2017.

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