What Is Diabetic Neuropathy?
Diabetic neuropathy, a complication of diabetes, damages the nerves in your body. It occurs most commonly in people living with diabetes for many years and people with frequent and/or extended high blood sugar levels.

Four types of neuropathy exist: peripheral, autonomic, proximal and focal.

 

  • Peripheral neuropathy, the most common type, can cause either pain or numbness in the toes, feet, legs, hands and/or arms.
  • Autonomic neuropathy affects nerves that control involuntary vital functions such as the heart muscle, smooth muscles like your stomach, blood vessels, glands and sexual organs. Autonomic neuropathy can also affect your blood pressure levels, your digestion, bladder and bowels, and even your sexual response.
  • Proximal neuropathy can affect your hips, thighs or buttocks - usually on one side. It can also lead to weakness in your legs.
  • Focal neuropathy can appear suddenly and often weakens one nerve or a group of nerves. It appears most often in the head, leg or torso.

Most neuropathies develop in stages. In the beginning, pain or tingling might come and go. Later, the pain can be more pronounced and occur more often. Eventually, the pain might go away because the nerve cells have died. If this occurs, you face a greater risk of injury simply because you can not feel pain in the damaged area.

What Causes Diabetic Neuropathy?
Decreased blood flow to the nerves can cause damage. And, although a major cause of diabetic neuropathy points to prolonged bouts of high glucose levels, researchers think the cause might actually involve a combination of factors which include:
  • Metabolism, such as duration of diabetes, abnormal blood fat levels, and high blood sugar levels
  • Factors affecting the blood vessels and capillaries that transport needed nutrients and oxygen to the nerves
  • Inflammation of the nerves caused by autoimmune factors
  • Mechanical injury to nerves, carpal tunnel syndrome
  • Genetic susceptibility to nerve disease
  • Use of alcohol and/or tobacco
How Do You Know If You Have Diabetic Neuropathy?
Symptoms of neuropathy often develop gradually, and they can differ depending on the type of the condition.

Some of the more common symptoms include:


Peripheral

  • Numbness or tingling in the arms or legs, often worse at night
  • Decreased (or loss of) sensation to a body part, such as arm, leg, hand, or foot
  • Burning sensation
  • Pain
  • Changes in your normal walk
  • Slower reflexes

Autonomic

  • Diarrhea
  • Constipation
  • Loss of bladder control
  • Increased urination at night
  • Impotence
  • Decreased vaginal lubrication
  • Bloating or feeling full after eating
  • Heartburn
  • Nausea
  • Vomiting
  • Fainting or dizziness
  • Low blood pressure
  • Difficulty swallowing

Focal

  • Drooping of the face, eyelid, or mouth
  • Vision changes
  • Abdominal or chest pain

Proximal

  • Leg weakness
  • Pain in the thigh, hips, legs, or buttock area
  • Difficulty moving from a seated to standing position

If your health care provider suspects you have diabetic neuropathy, he or she will likely conduct blood and imaging tests like an MRI to rule out other possibilities.

How Can You Treat Diabetic Neuropathy?
Nerve damage can progress if left untreated. To prevent the progression, you must keep your blood glucose levels under control. Doing so can help alleviate symptoms and lessen neuropathy progression. Sometimes, losing weight and exercising can reduce the symptoms.


Specific treatment methods often focus on reducing the discomfort caused by neuropathy.

Some people find some relief by using aspirin, acetaminophen or ibuprofen, especially when used regularly throughout the day. Topical treatments like lidocaine, capsaicin or Ben Gay might also provide temporary relief. Pain management techniques such as acupuncture, hypnosis or biofeedback might also help.

On occasion, prescription drugs might help some people as well. Some respond to certain antidepressants like Elavil, which can take a few weeks to begin working. Others find gabapentin (Neurontin), which blocks nerve signals, helpful.

If your muscles grow weak, you might need splints for additional support.

Researchers are also studying the effects of other drugs and treatments to help relieve the symptoms. Clinical trials that look at early diagnosis and better management are going on and might provide new information for improved treatments.

What Are the Complications of Diabetic Neuropathy?
Nerves do not grow back. If the pain of neuropathy turns into numbness, the nerve cells have died. If this happens, the numbness will not go away. This lack of sensation can increase your risk of injury and infections in the affected areas.


In addition, autonomic neuropathy can make you unaware if your blood sugar measures low. This highlights the importance of testing your blood glucose levels regularly.

How Can You Prevent Diabetic Neuropathy?
Keeping your blood sugar levels within the range set by your healthcare provider might forestall neuropathy.

In addition, take good care of your feet and legs if you have peripheral neuropathy. Doing so can minimize your risk of complications.

  • Clean your feet each day, and dry them thoroughly — even between the toes. Apply moisturizing lotion if your skin looks or feels dry.
  • After the cleaning, examine your feet and legs. Look for swelling, calluses, cuts, blisters or redness, and tell your doctor if you find any.
  • Cut and trim your toenails regularly. Go to a foot doctor or podiatrist if you need help.
  • Wear shoes or slippers that let your toes move. Use this footwear at all times in order to prevent injury. 

 

Reviewed by Clara Schneider MS, RD, RN, CDE, LDN - 05/13