Peripheral neuropathy is a condition that is, more often than not, referred to as "stocking glove syndrome" due to the fact that it most commonly affects the feet and hands. This condition can be particularly worrisome when it affects the feet, as there is often a greater chance that an injury may be inflicted without notice. The problem may often be compounded through the simple act of walking.
While there are quite a few people, especially those who have diabetes, who are aware of peripheral neuropathy and its signs and symptoms, there are significantly fewer who are educated about, or tested for, autonomic neuropathy. Autonomic neuropathy is considered a stealthy disorder as it tends to short-circuit nerves that control the sympathetic nervous system. Autonomic neuropathy has the ability to affect: blood pressure, heart rate, perspiration, salivation, gastrointestinal and bladder functions, sexual potency, and vision.
Cardiovascular Autonomic Neuropathy
Cardiovascular autonomic neuropathy is a disorder that often does not show symptoms, such as chest pain or discomfort, in it's earliest stages and it often remains undetected until a serious myocardial infarction has occurred. One of the results of this is that these "silent heart attacks" often pass without proper medical attention. A person who experiences any unexplained shortness of breath, weakness and fatigue, and/or any excessive perspiration, may have CAN as all are symptoms of a silent heart attack, and should be promptly reported to a doctor. Early diagnosis is essential for this disorder as there is a 50 percent mortality rate within five years of symptoms appearing.
While people who have diabetes may experience memory problems and cognitive impairment, it is not completely clear whether these problems result from physical processes, the social and/or psychological toll on the person, or due to a combination of these two problems.
Adhesive capsulitis, more commonly known as frozen shoulder, is a disorder that affects the connective tissue which limits the normal range of motion with the shoulder. For those affected by diabetes, this is often caused by changes to the collagen in the shoulder joint due to long term hyperglycemia. Although it can occur in both shoulders, usually only one is affected. The first line of treatment for this condition is physical therapy, along with anti-inflammatory medications, that is focused on improving the shoulder's range of motion.
Dupuytren's contracture is another condition that tends to limit range of motion. As suggested by its common name, trigger finger, this condition is characterized by pain, stiffness, and a "locking" within the index finger. These symptoms may appear due to an inflammation of the finger's tendon or as a result of the tendon sheath, or covering, becoming damaged. Flexibility gradually decreases and causes the finger to eventually lock up in a "trigger pull" position.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition that may often be confused or mistaken for peripheral neuropathy even though it involves nerve entrapment rather than nerve damage. This condition is often characterized by the median nerve becoming compressed, or entrapped, within the ligaments that surround it. One of the most common causes of CTS is repetitive stress, which can be exacerbated by diabetes as high blood glucose causes changes to the collagen in the ligaments, hence making entrapment of the nerve more likely.
Atherosclerosis and CAD
Atherosclerosis is more commonly identified as a hardening or clogging of the
arteries and is caused by a build-up of fatty material that restricts blood flow. For patients who have arterial obstructions, medications, such as nitroglycerin, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors, may be prescribed to alleviate this condition. Coronary artery disease (CAD) is a condition in which arteries that supply the heart are blocked. What makes this especially dangerous is that symptoms do not, typically, appear until the vessels are significantly blocked.
Peripheral Vascular Disease (PVD)
Peripheral Vascular Disease (PVD) is similar to CAD in that involves artheriosclerosis. Unlike CAD, however, PVD affects the extremities like, most commonly, the legs.
Hypertension, or high blood pressure, is another leading complication for diabetics. This condition arises within 65% of people who have diabetes. It is linked to both kidney disease and CAD, which makes it a critical condition to manage.
Ischemic stroke is another complication for diabetics that affects the cardiovascular system. This condition occurs when an artery, which leads to the brain, is cut off. Due to the complex interactions between diabetes and all anatomical systems, many complications arising from diabetes are related.
A primary cause of new-onset blindness, according to the ADA, in adults between the ages of twenty and seventy-four is diabetic retinopathy. It is caused due to a blockage and/or leakage of the blood vessels that feed the retina. Macular edema, which is caused due to a swelling of the macula (a part of the retina) is another possible complication and can cause blurred vision.
Glaucoma is caused due to a build-up of pressure in the eye that can damage the optic nerve. Normal cases are characterized by the eye's normal drainage patterns being blocked and the aqueous fluids within the eye building up and putting pressure on the optic nerve. A loss of peripheral vision is often the first sign of glaucoma.
People who have diabetes are not only more likely to develop cataracts at an earlier age, but are also twice as likely to develop them, than the general population. This condition is characterized by the lens of the eye becoming cloudy.
Because they filter approximately 50 gallons of fluid from the blood that passes through them, the kidneys are two of the hardest working organs in the body. After a million or so nephrons pass through them, and each kidney balances electrolytes and filters toxins out, approximately 49.5 gallons of fluid are returned to the bloodstream half cleansed and chemically and hormonally balanced. The remaining half gallon of fluid leaves the body as urine. Patients who have either Type 1 diabetes or Type 2 diabetes are at risk of developing kidney problems. The risk of developing ESRD also increases as the length of time since the diabetes has been diagnosed. This is possibly due to the prevalence of high blood pressure amongst people who have diabetes and the added stress that it places on the kidneys.
Gastroparesis, which is a delay of a stomach's emptying, literally signifies a partial paralysis of the stomach. It is another form of autonomic neuropathy and is caused due to the vagus nerve (responsible for facilitating the passage of food through the digestive system) being damaged. Gastroparesis is a special problem for people with diabetes as it can hinder efforts to control blood glucose levels.