Diabetic neuropathy is a common complication of diabetes, which affects approximately 30–60% of all diabetic patients. About 10–20% of patients with diabetes develop pain due to neuropathy. Most patients with pain experience a loss of sensation, which increases the risk of foot ulcers and other complications. Glycemic control and foot care are the two important measures that a victim of neuropathy management should undertake.
Prognosis of Diabetic Neuropathies
In most cases, prognosis for diabetic neuropathy depends on the appropriate management of blood sugar. Appropriate control of blood sugar with medications and lifestyle changes may halt the progression and improve symptoms of neuropathy, though the improvement is slow.
Pain in patients with peripheral diabetic neuropathy can be difficult to control. Several medications are used for the treatment of nerve pain in diabetes, but no particular drug has been found to be effective in all the patients. Most of these medications have several side effects. Your doctor will evaluate the benefits and side effects before prescribing the drug. Most people need a combination of medications or treatments (such as complementary and alternative therapies in addition to prescription medications) for relieving the pain in diabetic neuropathy. In diabetic neuropathy, prognosis or control of pain is better in patients with symptoms that last for <6 months' duration and are associated with alterations in glycemic control as compared with patients with chronic symptoms (symptoms present for longer than 6 months).
Studies suggest that the risk of death is increased in people with diabetic autonomic neuropathy. This probably occurs due to complications of diabetic autonomic neuropathy such as impaired heart rate variability (cardiovascular autonomic neuropathy)-this increases the risk of silent MI and death, renal failure and hypotension.
Prognosis is probably better for people with Radiculoplexus neuropathy (diabetic amyotrophy) and Mononeuropathy (focal neuropathy). Mononeuropathy can cause severe and sharp pain, but in most cases, it doesn't cause any long-term problem as the symptoms reduce and disappear in some time (over few weeks or months). Similarly, diabetic amyotrophy (diabetic proximal neuropathy) tends to gradually improve with time and with good blood sugar control. Some people, however, may be left with varying degrees of disability due to residual weakness or discomfort.
Severe pain and other complications of diabetic neuropathy such as chronic foot ulcer, amputation of foot due to foot ulcer may cause depression in some patients.The risk of lower limb amputation is higher in diabetics than non-diabetics.
Regular follow-up and good control of blood sugar can improve the prognosis. Your doctor can advise you regarding measures that can help you improve blood sugar control and prognosis of diabetic neuropathy.
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