Diabetic Neuropathy

Topic Overview

What is diabetic neuropathy?

Neuropathy means nerve disease or damage. Diabetic neuropathy is nerve damage caused by diabetes. People who have diabetes often have high blood sugar levels. Over time, high blood sugar levels can damage nerves throughout your body.

There are three kinds of diabetic neuropathy.

Peripheral neuropathy is damage to peripheral nerves. These are the nerves that sense pain, touch, hot, and cold. They also affect movement and muscle strength. The nerves in the feet and lower legs are most often affected. This type of nerve damage can lead to serious foot problems. The damage usually gets worse slowly, over months or years.
Autonomic neuropathy is damage to autonomic nerves. These nerves control things like your heartbeat, blood pressure, sweating, digestion, urination, and sexual function.
Focal neuropathy affects just one nerve, usually in the wrist, thigh, or foot. It may also affect the nerves of your back and chest and those that control your eye muscles. This type of nerve damage usually happens suddenly.

What causes diabetic neuropathy?

Over time, high blood sugar levels from diabetes can damage nerves throughout your body. The higher your blood sugar levels, the more likely you are to have nerve damage. So controlling your blood sugar throughout your life is very important.

The older you get, and the longer you have diabetes, the more likely you are to have nerve damage. People who have diabetes who drink too much alcohol are also more likely to have nerve damage.

What are the symptoms?

Your symptoms will depend on which nerves are injured. You may not be able to feel pain, especially in your feet. This can lead to serious infections, because sores or other problems may not get treated.

When other parts of your body are affected, symptoms may include:

Problems with digestion, such as bloating, belching, constipation, nausea and vomiting, diarrhea, and belly pain.
Problems with body temperature, such as heavy sweating at night or when you eat certain foods. Some people may have reduced sweating, especially in their feet and legs.
Problems with urination, such as finding it hard to tell when your bladder is full or finding it hard to empty your bladder completely.
Sexual problems, such as erection problems in men and vaginal dryness in women.
Heart and blood vessel problems, leading to poor circulation or low blood pressure. This may cause dizziness, weakness, or fainting when you stand or sit up from a reclining position.
Trouble sensing when your blood sugar is low.

How is diabetic neuropathy diagnosed?

Your doctor will check how well you feel light touch and temperature and will test your strength and your reflexes. Tests such as electromyogram and nerve conduction studies may be done to confirm the diagnosis. You may need other tests to see which type of neuropathy you have and to help guide your treatment.

Doctors can't test for all types of nerve damage. So it's important to tell your doctor about any pain or weakness you feel. Also mention heavy sweating or dizziness and any changes in digestion, urination, and sexual function.

How is it treated?

Treatment involves keeping blood sugar levels in your target range. This will not cure the nerve damage, but it can help keep the damage from getting worse, and the pain might get better.

Other treatment depends on your symptoms:

Pain may be treated with medicines.
Digestive system problems or blood vessel problems may be treated with medicines.
Blood pressure problems may be treated with medicines and by wearing support stockings (also called compression stockings).
Sexual problems may be helped with medicines or devices to improve erections or with lubricating creams that help vaginal dryness.
A splint or brace may be used for a pinched nerve.

When you have diabetes, you could have a sore or other foot problem without noticing it. Check your feet every day. An untreated problem on your foot can lead to a serious infection or even amputation.

Be clear with your doctor about what is helping you feel better and what is not. You and your doctor can work together to find the treatment that helps you the most.

Can diabetic neuropathy be prevented?

Keeping your blood sugar levels in your target range, set with your doctor, may help prevent neuropathy from ever developing. The best way to do this is by checking your blood sugar and adjusting your treatment. It is also important to get to and stay at a healthy weight by exercising and eating healthy foods.

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