Some diabetes patients can develop a type of nerve damage called diabetic neuropathy. This damage is a serious but common complication associated with diabetes. There are four kinds of diabetic neuropathy, and an affected individual can have more than one type. Peripheral neuropathy is a variation that mainly affects the extremities of the body or the feet and hands. Autonomic neuropathy is a variation that affects the autonomic nervous system or the bladder, stomach, heart, intestines, eyes, and sex organs. Radiculoplexus neuropathy is a variation of diabetic neuropathy that affects nerves in the buttocks, legs, hips, or thighs. Mononeuropathy is a variation characterized by damage to a particular nerve in the middle of the body, leg, or face. Poor diabetes management and persistent high blood sugar levels are the biggest risk factors for diabetic neuropathy.
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Muscle weakness is characterized by the inability to produce a normal muscle movement or contraction with the individual's full effort. Voluntary muscle movements are produced when an individual's brain transmits a signal through their spinal cord, and then out through the nerve roots into branching nerves responsible for the stimulation of the muscles. If the connections between the brain, spinal cord, nerve roots, branching nerves, or muscles are disrupted or impaired, the muscles will not receive the signal that tells them how and when to contract or relax. Muscle weakness is commonly seen as a symptom in the peripheral and radiculoplexus variations of diabetic neuropathy. When muscle weakness occurs due to damage to the nerves, there is a significant reduction in the use of the affected muscle or muscles. When muscles go for long periods without regular use, they begin to lose their size, function, and density. Muscle weakness can cause an individual to have difficulty with walking, standing up, general coordination, balance, and a number of other basic bodily movements.
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Urinary Incontinence Or Retention
Urinary incontinence or retention are symptoms of diabetic neuropathy some patients present with. When an individual is unable to hold urine in their bladder properly, it is called urinary incontinence. When an individual is unable to empty their bladder properly, it is called urinary retention. The actions of the bladder are controlled by the individual's autonomic nervous system that acts unconsciously to regulate numerous bodily functions. Patients with autonomic neuropathy can experience urinary incontinence if there is a disruption in the nerve signals that tell the internal and external urethral sphincters when to contract and relax. Incontinence can also occur if there is a disturbance in the signals being sent to and from the bladder muscle itself, causing it to contract and leak out urine inappropriately. The patient may experience urinary retention when the signals from the brain do not reach the bladder or urinary sphincters at all, or when the signals do not stimulate a bladder muscle contraction at the correct timing in relation to sphincter relaxation. This signal obstruction can cause the patient to be unable to empty the bladder fully or urinary retention.
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Both the autonomic and radiculoplexus variants of diabetic neuropathy can cause a patient to bloat or swell in their abdominal area. This symptom occurs because high glucose can easily damage the nerves that control the muscles responsible for moving food through the digestive tract properly. When these nerves in the abdomen become damaged and impair signals to the abdominal muscles, food will not move through the digestive tract as fast as it should. Consequently, food tends to sit in the affected individual's stomach for an extended period. When food sits in the stomach too long, bacteria in the food itself and the stomach begin to consume its rotting contents before it can be digested. This bacterial consumption creates byproducts, some of which are in the form of gas. The buildup of gas in the stomach and intestines along with the inflammation that results from gastroparesis causes the patient's abdominal area to appear swollen or abnormally full.
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A diabetes patient with diabetic neuropathy may experience weight loss. There are numerous mechanisms in diabetic neuropathy that can cause an individual to lose weight. Muscle weighs more then fat does, and reduced muscle use as a result of diabetic neuropathy can cause a significant loss in muscle size and tone. This loss equates to a loss of muscle weight in the body. In addition, a patient who has damage to the nerves that control digestion in the stomach and intestines can experience weight loss. This loss occurs because the food an individual consumes does not move through the digestive system when it should, stagnating and causing the patient to experience nausea, vomiting, and a loss of appetite. This means the individual being affected this way will not consume normal amounts of food on a regular basis as they should. Furthermore, diarrhea can also result from damage to the nerves that control food movement. A loss of fluids from diarrhea can cause a patient to lose weight.
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Tingling And Burning Sensations
A common manifestation of diabetic neuropathy is tingling and burning sensations anywhere around a patient's body. These sensations occur most often in the limbs and the extremities. The sensitive nerves in an individual's hands and feet are especially susceptible to damage from extended high glucose levels. A painful sensation of burning usually manifests as an early symptom of progressive damage to the nerves. The burning usually starts in the patient's feet and lower legs, and then it may move to their hands and arms. Tingling sensations usually manifest when the damage to the nerves has become more advanced. This symptom happens when the nerves in the affected area receive partial transmissions from other nerves. However, irregular and weak signals still may periodically make it to the extremities and back to the brain, which causes an odd tingling sensation. Most patients feel the tingling and burning sensations when the affected area has external stimuli, but the sensations can occur spontaneously as well.