What is diabetic neuropathy ?

When the nerves are affected by diabetes, a person is said to have diabetic neuropathy. Possibly the commonest long term complication of diabetes, the biggest problem is that in many patients the signs that they have diabetic neuropathy are so subtle, that it's presence only comes to light when the patient comes with a complication caused by the nerve disorder, such as a foot ulcer, etc.

People with diabetes can develop nerve problems at any time. Significant clinical neuropathy can develop within the first 10 years after diagnosis of diabetes and the risk of developing neuropathy increases the longer a person has diabetes. Some recent studies have reported that:

• 60 percent of patients with diabetes have some form of neuropathy, but in most cases (30 to 40 percent), there are no symptoms.
• 30 to 40 percent of patients with diabetes have symptoms suggesting neuropathy, compared with 10 percent of people without diabetes.

To compound the difficulty of detecting it, diabetic neuropathy itself has a slow and insidious onset. Patients often say that they were at first unaware of growing numbness in their feet and hands.

But it is absolutely essential that you must have yourself tested for neuropathy, as diabetic nerve disease can lead to many serious complications.

How?

To understand this, let us briefly consider the role played by the nerves.

What does my nervous system do?

Tasting, smelling, seeing, hearing, thinking, dreaming, breathing, heart beating, moving, running, sleeping, laughing, singing, remembering, feeling pain or pleasure, painting, writing...you couldn't do any of these things without your nervous system!

Made up of your brain, your spinal cord, and an enormous network of nerves that thread throughout your body, it's the control center for your entire body. Your brain uses information it receives from your nerves to coordinate all of your actions and reactions. Without it, you couldn't exist!

That's how important your nervous system is.

It is the nerves which make up the peripheral nervous system which carry messages back and forth between the brain and other parts of the body.

What are nerves?

They're the thin threads of nerve cells, called neurons that run throughout your body. Bundled together, they carry messages back and forth just the way that telephone wires do. Sensory nerves send messages to the brain and generally connect to the brain through the spinal cord inside your backbone. Motor nerves carry messages back from the brain to all the muscles and glands in your body.

So how do they pass along messages?

Through the marvels of chemistry and a kind of electricity! Neurons are thin. Some are very small, and some can be three feet long! All are shaped somewhat like flat stars which have, to varying degrees, been pulled at each end so that they have long fingers. The fingers of one neuron almost reach to the next neuron.

When a neuron is stimulated -- by heat, cold, touch, sound vibrations or some other message -- it begins to actually generate a tiny electrical pulse. This electricity and chemical change travels the full length of the neuron. But when it gets to the end of finger-like points at the end of the neuron, it needs help getting across to the next extended finger. That's where chemicals come in. The electrical pulse in the cells triggers the release of chemicals that carry the pulse to the next cell. And so on and on till it reaches its destination. Impulses travel through the nerve network to the brain at a rate of 350 feet per second!

It takes the corporation of three system to carry out the mission of the nervous system . They are the central, the peripheral nervous systems.

The central nervous system has the responsibility for issuing nerve impulses and analyzing sensory data, and includes the brain and spinal cord.

The peripheral nervous system is responsible for carrying these nerve impulses to and from the body.

The peripheral nervous system is subdivided into the

• sensory-somatic nervous system and the
• autonomic nervous system

Whilst some divide the nerves in the body into the peripheral nervous system and those in the autonomic nervous system, today, most feel that that one should use the term Peripheral Nervous System for all the nerves not considered to be part of the central nervous System, and then divide these into the Sensory-Somatic Nervous System ( what has popularly been called the peripheral nervous system in the past) and the Autonomic Nervous System.

This helps to describe their functions better.

The somatic nervous system consists of peripheral nerve fibers that send sensory information to the central nervous system AND motor nerve fibers that project to skeletal muscle.

The autonomic nervous system is composed of the sympathetic and parasympathetic systems and is responsible for regulating and coordinating the functions of vital structures in the body

The autonomic nervous system controls smooth muscle of the viscera (internal organs) and glands.

By understanding the important role played by the nerves, one can well realize the importance of the problems that can arise when these nerves cannot function properly when damaged by diabetes.

Whilst, diabetes can affect the Central Nervous System (CNS), it is the Peripheral Nervous System (PNS) which has been the focus of diabetic neuropathy.