Dr. Joe’s neuropathy explanation
Peripheral neuropathy is what most people think of
when thinking of diabetic neuropathy. Numbness or
pain in the legs is their idea of what is wrong. The
legs have the longest nerves in the body and
therefore seem to be prone to poor metabolic
control of the very small blood vessels around the
nerves. Elevated blood glucose itself delays nerve
conduction and eventually causes damage, not just
impairment. Early detection allows early treatment
and possible reversal of the problem.
Peripheral neuropathy testing has been easily done
with nylon elements of varying sizes. More recently,
electronic testing has yielded more reproducible
results.
The autonomic nerves are also long. Although
some sensory nerves travel with them, they usually
do not have any pain symptoms which people would
call neuropathy. They do affect the eyes, heart,
respiratory function, hypoglycemic unawareness,
gastrointestinal tract and sexual dysfunction.
The testing for autonomic dysfunction has traditionally
been very difficult. The symptoms of dysfunction are
often recognized as being part of diabetes but difficult
to treat. Symptoms, in the early stage, are easy to
ignore. Why am I not surprised that the world knows
little about autonomic neuropathy?
Since the cause of these two neuropathies are the
same, the testing for one will tend to indicate you
may have the other problem as well. Treatment will
be similar.
The white knight that has ridden on the scene to make
testing simple is the personal computer. Calculations
that would take almost a day are done in seconds.
Measurements that were tedious and inaccurate are
now swift and sure. Digital transmission to reading
centers such as Boston Medical Technologies does
add a scientific rigor that makes us all feel better.
And it doesn’t physically hurt when you are tested.
Dr. Joe, the Diabetes Doctor