Diabetes sparks a rise in neuropathy

July 13, 2017 by Scott Gilbert, Pennsylvania State University
Credit: Thinkstock/Ralwel

Autonomic and small fiber neuropathy used to be considered rare conditions. But with approximately 30 million Americans affected by diabetes—one of the main underlying causes for these diseases—it's an emerging problem.

Both types of occur when small blood vessels supplying the nerves get damaged by diabetes—they begin to die because they don't get enough oxygen and nutrients.

In the case of autonomic neuropathy, involuntary bodily functions such as , digestion, sexual function, urination, and temperature control and sweat regulation are often affected.

"The most common is light headedness, especially when standing up. The blood pressure drops so much when they stand up that they feel like they are going to pass out," said Dr. Divpreet Kaur, a neurologist at Penn State Health Milton S. Hershey Medical Center.

In small fiber neuropathy, the damage occurs to nerve fibers that control pain and temperature sensations. Kaur said people with this condition often experience burning pain in their feet that eventually progresses up their legs or develops in their hands, as well.

"People don't know about it or recognize the symptoms, and they keep going to different physicians without receiving a diagnosis," she said. "It isn't that every patient who has these symptoms will definitely have such a neuropathy. Once common things have been ruled out by their , they can be referred to the neuromuscular clinic for consultation or to the autonomic laboratory for further testing."

Kaur recommends that people with diabetes, pre-diabetes or metabolic syndrome with hyperlipidemia see their primary care provider at the onset of such symptoms. Others who should do so include people with vitamin deficiency or toxicity, genetic like amyloidosis, or a history of chemotherapy or radiation treatment.

A skin biopsy—the gold standard of testing for small fiber neuropathy—can be performed at the neuromuscular clinic at Hershey Medical Center, as can autonomic testing that involves collecting heart rate response to deep breathing, and sweat response.

There is no cure for either type of neuropathy, and treatments vary depending on the part of the body affected and the symptoms. When the cause is an underlying condition such as diabetes, controlling and treating that disease can help stabilize or slow the progression of neuropathy. In nearly a third of patients, though, doctors can't find an underlying condition. In such cases—called idiopathic neuropathy—they can only treat the symptoms to improve the quality of life for the patients.

In small fiber neuropathy, treatment often involves controlling pain. For autonomic neuropathy, medications can be used to help regulate the bodily functions that are no longer working as they should, such as for orthostatic hypotension or urinary problems.

Explore further: Autonomic neuropathy after chemotherapy—is it permanent?

Related Stories

Autonomic neuropathy after chemotherapy—is it permanent?

February 22, 2017
Dear Mayo Clinic: After six months of chemotherapy, I developed autonomic neuropathy. I have been done with chemotherapy for a few months, but the neuropathy has not gone away. Is there a chance it could be permanent?

CV autonomic neuropathy predicts urological issues

May 21, 2015
(HealthDay)—For men with type 1 diabetes, cardiovascular autonomic neuropathy is associated with erectile dysfunction and/or lower urinary tract symptoms, according to a study published in the June issue of The Journal ...

What primary care providers should know about diabetic neuropathy

January 30, 2017
An estimated 60 to 70 percent of people with diabetes develop some form of diabetic neuropathy, or the chronic nerve damage diabetes causes, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

'Substance P' in tears—a noninvasive test for diabetes-related nerve damage?

July 5, 2017
Levels of a nerve cell signaling molecule called substance P—measured in tear samples—might be a useful marker of diabetes-related nerve damage (neuropathy), suggests a study in the July issue of Optometry and Vision ...

Small nerve fibers defy neuropathy conventions

April 11, 2016
Results of a small study of people with tingling pain in their hands and feet have added to evidence that so-called prediabetes is more damaging to motor nerves than once believed, in a report on the study published online ...

Recommended for you

Diabetes gene found that causes low and high blood sugar levels in the same family

January 15, 2018
A study of families with rare blood sugar conditions has revealed a new gene thought to be critical in the regulation of insulin, the key hormone in diabetes.

Discovery could lead to new therapies for diabetics

January 12, 2018
New research by MDI Biological Laboratory scientist Sandra Rieger, Ph.D., and her team has demonstrated that an enzyme she had previously identified as playing a role in peripheral neuropathy induced by cancer chemotherapy ...

Enzyme shown to regulate inflammation and metabolism in fat tissue

January 11, 2018
The human body has two primary kinds of fat—white fat, which stores excess calories and is associated with obesity, and brown fat, which burns calories in order to produce heat and has garnered interest as a potential means ...

Big strides made in diabetes care

January 5, 2018
(HealthDay)—This past year was a busy, productive one for diabetes research and care.

Gene therapy restores normal blood glucose levels in mice with type 1 diabetes

January 4, 2018
Type 1 diabetes is a chronic disease in which the immune system attacks and destroys insulin-producing beta cells in the pancreas, resulting in high blood levels of glucose. A study published January 4th in Cell Stem Cell ...

Goodbye, needles? Patch might be the future for blood-sugar tracking

January 4, 2018
(HealthDay)—Developers of a new patch hope to eliminate a big barrier in type 2 diabetes treatment—painful finger-sticks and injections. The new patch—which actually uses an array of tiny needles that researchers promise ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.