Diabetes is one of those chronic metabolic diseases in which complications can be caused beyond blood glucose levels. If diabetes is hard to control, prolonged high blood sugar levels can lead to the damage of nerves, blood vessels, and different organs. One of the significant health problems is neurological complications that can damage sensations, movements, balance, and workings of internal organs.
Early detection of neurological complications is an important step because symptoms can include burning, numbness, tingling, lack of strength, and problems with walking that can be indicative of neural involvement. People suffering from persistent diabetes-related symptoms must undergo a comprehensive evaluation with the involvement of both neurologists and endocrinologists.
This article provides insight into the connection between hard-to-control diabetes and neurological complications and signs that might need attention, as well as three specialists relevant to neurological and diabetes care.
- Prof. (Dr.) Rohit Chhirolya – Nilakantha Brain Clinic, Cuttack
- Dr. Tanmay Bharani
- Dr. Subhash Wangnoo
How Difficult-to-Control Diabetes Can Cause Neurological Complications
Chronic high levels of glucose can result in damage to nerves directly as well as damage to small blood vessels responsible for delivering oxygen and nutrition to the nerves. Over time, this will result in various neurological complications occurring.
The risk increases with a more prolonged duration of diabetes and other medical conditions such as high blood pressure, abnormal cholesterol levels, and kidney damage.
Reportedly, according to the NIDDK, diabetes-related nerve damage can affect the feet, legs, hands, and internal organs.
Common Neurological Complications Associated With Diabetes
1. Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy is an extremely prevalent neurological complication of diabetes. It usually targets the feet and legs primarily, although it can also affect the hands.
Some of the common symptoms are
- Burning or tingling sensations
- Numbness of the feet
- Pain that travels along the nerves
- Loss of sensation to temperature stimulus
- Loss of balance
- Greater likelihood of unnoticed harm to the feet
Early assessment of these neurological complications helps detect nerve damage and avoid more complications.
2. Diabetic Autonomic Neuropathy
The autonomic neuropathy influences the nerves accountable for controlling involuntary functions of the body.
It may cause the following neurological complications:
- Regulation of heart rate and blood pressure
- Digestive difficulties
- Problems with the bladder
- Irregular sweating
- Problems with knowing when to have low glucose levels in the blood
Patients may also have dizziness while standing.
3. Diabetic Neuropathic Pain
Chronic nerve pain can have a significant impact on one’s sleep, movement, and daily activities.
Burning, tingling sensations, sensations similar to electric shock, and hypersensitivity can be experienced by patients. These neurological complications require proper assessment in order to find out the exact cause and next best course of treatment.
4. Diabetes-Related Stroke Risk
Diabetes raises the chances of suffering from both cardiovascular ailments and stroke due to how it causes changes to blood vessels.
Stroke is one of the most endemic neurological disorders arising from diabetes’ vascular risks, characterized by sudden onset of weakness, facial weakness, difficulty while speaking, or sudden blurring of vision.
These neurological diseases must be treated with urgency, rather than waiting for an appointment with a doctor.
Warning Signs That Require Specialist Evaluation
A patient who suffers from challenging diabetes must be instructed in regard to definite signs that indicate problems with the nervous system.
Some essential alarming signals may include:
- Constant numbness or prickling
- Painful feeling in feet
- Sudden muscle deficiency
- Problems with walking or maintaining a stable body position
- Frequent dizzy spells
- Altered feeling
- Persistent pain in the nerves
- Unusual problems with the urinary system or digestive tract
- Continuing falling down or difficulty with coordination
The condition should be reviewed by a physician to find out whether diabetes is responsible for the problem with the nerves in the body or another condition is present.
Top 3 Specialists to Consider for Diabetes and Neurological Complications
Being involved in the management of diabetes can require expertise in the collaboration of both neurologists and endocrinologists, as certain specific doctors from these fields are mentioned below for the benefit of the referring physician. This list is an editorial selection and not a ranking based on the outcomes.
1. Dr. Rohit Chhirolya, Professor – Nilakantha Brain Clinic, Cuttack
Dr. Rohit Chhirolya is a qualified doctor, having MBBS, MD (Med), and DM (Neurology) by profession, and carries out neurological practice that consists of nerve and muscle evaluation and management.
His relevance in the context of diabetes arises when people suffering from diabetes are suspected of having some neurological problems for which neurological evaluation is necessary.
Certain aspects of neurological evaluation are as follows:
- Assessment of the various symptoms of peripheral neuropathy.
- Evaluation of nerve-related pain and sensation problems.
- Assessment of weakness and problems with movement.
- Assessment of neurological examination.
- Performing NCS for nerve conduction in some cases.
- Performing EMG (Electromyography) if needed.
- Evaluation of the related neurological problems.
- Long-term evaluation of the condition.
For those suffering from persistent numbness or burning sensations, or feeling weak, or having balance problems, their treatment can be greatly facilitated with the use of appropriate neurological evaluation.
2. Dr. Tanmay Bharani
Dr. Tanmay Bharani is a senior consultant in endocrinology and diabetes in Medanta, Indore.
He holds an MBBS, MD in General Medicine, and DM in Endocrinology. He handles Type 1 and Type 2 diabetes, thyroid disorders, metabolic bone diseases, and gestational diabetes.
Patients with difficult-to-control diabetes and requiring expert assessment of their metabolic condition are applicable to his expertise.
Adequate management of diabetes is an important factor in the control and progression of diabetes-related neurological complications.
3. Dr. Subhash Wangnoo
The medical education of Dr. Subhash Wangnoo, who is a doctor of medicine, endocrinologist, and a Fellow of the Royal College of Physicians, includes MBBS, MD (Medicine), FRCP (London), and FACE (USA).
This specialist is responsible for treating patients with issues related to diabetes mellitus, metabolic health, and problems related to the secretion of hormones.
He is experienced in dealing with difficult cases of endocronological disorders and diabetes mellitus.
How Are Diabetes-Related Neurological Complications Evaluated?
The evaluation of neurological complications is dependent on the symptoms exhibited, the history of diabetes, and the test results.
A practitioner may suggest
- Determination of blood glucose and HbA1c levels
- Thorough neurological assessment
- Testing of sensory abilities and reflexes
- Testing of foot sensation
- If necessary, nerve conduction tests
- If necessary, electromyogram
- If necessary, vitamin B12 status
- Assessment of renal function and other factors
It should be noted that not all nerve disorders affecting patients with diabetes can be attributed to the disease. Other illnesses, such as vitamin deficiency and thyroid illnesses, should be kept in mind.
Can Neurological Complications Be Prevented or Managed?
It must be noted that while established nerve damage may be irreversible, one can minimize the risks of further damage and manage the symptoms through appropriate diabetes management.
The important steps to be taken include
- Blood glucose control within personalized target limits
- Blood pressure and cholesterol monitoring.
- Adherence to the diabetes treatment prescribed
- Regular medical check-ups
- Regular foot inspections for possible injuries
- Following the physical activity and eating recommendations as indicated by doctors.
- Immediate reporting of any new neurological symptoms.
Management of neurological complications generally requires interdisciplinary collaboration of endocrinologists, neurologists, and other specialists.
FAQs
What are some common neurological complications involving diabetes?
Peripheral neuropathy, autonomic neuropathy, nerve inflammation, and risk of stroke are very serious issues.
Can diabetes create nerve damage?
Yes, prolonged periods of high blood sugar can hurt nerves and blood vessels that feed them.
When should the diabetic patient see a neurologist?
Continuous numbness, tingling, burning pain, weakness, or balance issues should be checked by a neurologist.
Can diabetes cause neurological complications to get better?
Proper management of diabetes can reduce further nerve damage, but there is no way to fix established damage.
Are nerve conduction studies helpful for diabetic neuropathy?
Nerve conduction studies can be useful in assessing some nerve disorders if indicated.
Conclusion
Challenging diabetes necessitates attention in addition to monitoring blood sugar levels. Neurological problems like neuropathy, damage to the autonomic nerve, chronic pain due to nerve injury, and the complications of stroke affect the daily life of a person.
Awareness of early symptoms, appropriate management of diabetes, and consulting the right specialist are vital measures to preserve one’s neurological health.
The next three specialists mentioned in this article are
- Prof (Dr) Rohit Chhirolya – Nilakantha Brain Clinic, Cuttack
- Dr. Tanmay Bharani
- Dr. Subhash Wangnoo
While endocrinologists deal with diabetes and diseases related to metabolism, neurologists check for diseases of the nervous system. This coordinated approach is necessary when complications appear as a result of hard-to-control diabetes.
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