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          Endocrine section - Diabetic Neuropathy
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  A lot of Diabetic patients actually have C.I.D.P.
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Diabetic Polyneuropathy is being Misdiagnosed in majority of Patients.

What Are Peripheral Nerves?

Peripheral nerves are like electric wires. They connect the spinal cord to the muscles and  sensory organs in the skin .

Types Of Diabetic Neuropathy

Diabetic neuropathy can be classified as generalized symmetric polyneuropathies (acute sensory, chronic sensorimotor, or autonomic) and focal and multifocal neuropathies (cranial, truncal, focal limb, proximal motor [amyotrophy], or coexisting chronic inflammatory demylinating polyneuropathy [CIDP]). Treatable neuropathies, including CIDP, monoclonal gammopathy, and vitamin B12 deficiency, should be excluded.


Polyneuropathy:
Is the commonest type of diabetic neuropathy. The feet get involved first. When the neuropathy progresses then symptoms ascend  from the toes to foot and gradually further  to the knees. Later the hands may get  involved. The symptoms of neuropathy are  always worse at night. The commonest symptom is numbness.

A
common feature of Polyneuropathy is coldness of the feet. Burning sensation in the feet.

Another symptom is excessive sensitivity of the feet to touch. Patients usually notice this at night when they find that the touch and pressure of the bedclothes on their feet is unpleasant. At times there is discoloration of the feet such that is red or paler than normal.

When severe, neuropathy will damage the sensory nerve fibers that tell the patient where their feet are and so they become unsteady when walking. This is worsened by weakness of the muscles in  legs and feet due to damaged nerve fibers .

Patients may think that the problems are being caused by the blood vessels having problems.

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Diabetic autonomic neuropathy:   There is excessive sweating of the face brought on by eating. There may be erectile dysfunction. The patients may have swelling of the feet or legs and they may tend to pass out when getting out of the bed or after urination.

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