Diabetic polyneuropathy is one of the most common complications of diabetes, says Prof. Stefka Mantarova, PhD, who heads the Clinic for Functional Diagnostics of the Nervous System at the Academy of Medical Sciences. About half of diabetics suffer from it. In some symptoms of polyneuropathy are detected even at the very beginning after the diagnosis of diabetes.
In these cases, the peripheral nervous system is damaged. The manifestations are in a different form, in direct relation to which structures in the body are affected. Polyneuropathy is defined as damage to two or more peripheral nerves. Here is what Associate Professor Mantarova also says.
Symptoms related to the senses are most common
They can be defined as excitatory or aversive. It is characteristic that the complaints start from the toes. They progress upward, may reach as far as the knees, as well as be expressed in the upper limbs. The typical complaint is of pain, which has a different strength and is felt in a different way. Sometimes it's burning, other times it's tight or tearing. Patients also report changes in sensory sensations:
- dysesthesias (pins and needles, tickling, tingling, crawling ants, etc.),
- hypersensitivity to touch (allodynia),
- feeling that they are wearing socks or that they are stepping on cotton.
Overnight unpleasant sensations in the legs are more intense and may interfere with sleep. In addition, one can easily injure or burn oneself because the normal protective sensation of pain and temperature is missing. Small sores can easily be missed and become infected.
A facial nerve can also be affected
In asymmetric forms of neuropathy, the involvement of nerves that are involved in the movement of the eyes is often found, says Prof. Mantarova. One feels pain and sees double. The good thing is that patients recover spontaneously within 3 months in most cases.
Less commonly, type 2 diabetes causes facial nerve involvement. This problem is often repeated (recurrences), and can cover both sides of the face.
Changes in taste are not observed, and recovery occurs spontaneously, although it takes 3 to 6 months. In rarer forms, vision loss is also observed - for example, in anterior ischemic optic neuropathy.
Neuropathy affects the stomach - sweating during meals
Neuropathy also has symptoms related to the gastrointestinal tract. Nausea, vomiting after eating, bloating, difficulty swallowing, nocturnal diarrhea or constipation are among the gastrointestinal manifestations of neuropathy.
Some people have impaired sweat secretion. It is possible that it is reduced, even absent (anhidrosis), or it is increased (hyperhidrosis).
It's very characteristic the sweating during meals, Prof. Mantarova points out. Over 50% of diabetics suffer from bladder dysfunction, and erectile dysfunction is often found in men. Although rare, the so-called autonomic symptoms. Symptomatic autonomic neuropathy is uncommon and usually develops later in the course of the disease. Intolerance to physical exertion, tachycardia at rest, orthostatic hypotension (dizziness, weakness and a decrease to syncope when standing up from a lying or sitting position) appear, says the neurologist.