Diabetic Neuropathy Treatment in Bangalore

Diabetic Neuropathy – Causes, Symptoms, Diagnosis & Advanced Treatment

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What Is Diabetic Neuropathy?

Diabetic neuropathy is a condition where nerves become damaged due to long-standing elevated blood glucose levels. This nerve damage affects:

Sensation (sensory nerves)
Muscle movement (motor nerves)
Sweating and circulation (autonomic nerves)

Over time, patients may experience:

Numbness
Tingling
Burning pain
Loss of feeling
Foot injuries without pain
Balance problems

If not treated early, neuropathy can lead to ulcers, deformities, falls, and infections.

Causes of Diabetic Neuropathy

Diabetic neuropathy is caused by a combination of metabolic and vascular factors:

1. Uncontrolled Blood Sugar

High glucose levels damage nerves and reduce their ability to transmit signals.

2. Reduced Blood Supply to Nerves

Diabetes affects small blood vessels supplying nerves, leading to nerve ischemia and degeneration.

3. Metabolic Dysfunction

High blood sugar produces toxic byproducts:

Sorbitol
Advanced glycation end-products (AGEs)
These damage nerve fibers.

4. Inflammation

Chronic inflammation in diabetics contributes to nerve injury.

5. Lifestyle Factors

Obesity
Smoking
High cholesterol
Alcohol use

increase the risk and severity of neuropathy.

Pathology of Diabetic Neuropathy (What Happens Inside the Body?)

Diabetic neuropathy involves multiple pathological changes:

1. Nerve Fiber Degeneration

Loss of myelin (protective nerve covering)
Axon damage (nerve fiber injury)
Slowed nerve conduction

2. Microvascular Damage

Blood vessels supplying nerves become narrowed, reducing oxygen delivery.

3. Accumulation of Toxic Metabolites

High glucose leads to the buildup of sorbitol and fructose inside nerves, causing swelling and dysfunction.

4. Oxidative Stress

Free radicals damage nerve cells and worsen neuropathy.

5. Loss of Protective Sensation (LOPS)

Nerve degeneration leads to:

Numbness
Painless injuries
Increased ulcer risk

Diabetic Neuropathy symptoms

Symptoms vary depending on the severity and type of nerve damage. They may develop gradually or worsen suddenly.

Common Symptoms:

Numbness or reduced ability to feel pain
Tingling or “pins and needles” sensation
Burning or stabbing pain
Sharp electric-shock–like pain
Increased sensitivity to touch (hyperesthesia)
Muscle weakness or cramps
Loss of balance
Dry or cracked feet due to reduced sweating
Deformities like hammer toe, claw toe
Ulcers due to unnoticed injuries

Advanced Symptoms:

Complete loss of sensation
Charcot foot (bone & joint destruction)
Frequent falls
Serious foot infections

Diagnostic Tests for Diabetic Neuropathy

A thorough evaluation helps detect neuropathy early and prevent complications.

1. Clinical Examination

Sensory test for touch, pain & temperature
Muscle strength testing
Balance assessment
Checking for calluses, cracks, or ulcers

2. Monofilament Test

A simple test using a nylon filament to check loss of protective sensation.

3. Vibration Test (128 Hz Tuning Fork)

Assesses vibration sensation at the big toe and ankle.

4. Nerve Conduction Studies (NCS) / Electromyography (EMG)

Measures how fast nerves carry signals; helpful in advanced cases.

5. Biothesiometry

Quantifies vibration perception threshold.

6. Reflex Testing

Achilles tendon reflex helps detect early neuropathy.

7. Foot Pressure Scan

Identifies high-pressure areas that can lead to ulcers.

8. Blood Tests

To evaluate:

Blood sugar levels
HbA1c
Vitamin B12
Thyroid function