What is diabetic neuropathy?
Neuropathy refers to nerve disease or nerve damage. Diabetic neuropathy is nerve damage caused by diabetes. People with diabetes usually have high blood sugar levels. High blood glucose levels can gradually damage nerves throughout the body.
There are three types of diabetic neuropathy:
- Peripheral neuropathy, is damage to the peripheral nerves. Peripheral nerves are the nerves that feel pain, touch, hot and cold. They also affect movement and muscle strength. The nerves in the foot and lower leg are most often affected. This nerve damage can lead to serious foot problems. The injury usually develops slowly, over months to years.
- Autonomic neuropathy, is damage to the autonomic nerves. Autonomic nerves control heart rate, blood pressure, sweating, digestion, urinary and sexual function.
- Focal neuropathy, which affects only one nerve, usually the nerve in the wrist, thigh, or foot.
It may also affect the nerves in the thoracic back and the nerves that control the eye muscles. This type of nerve injury usually occurs suddenly.
What causes diabetic neuropathy?
High blood glucose levels in people with diabetes can gradually damage nerves throughout the body. The higher the blood glucose level, the more likely nerve damage is to occur. Therefore, lifelong blood glucose control is extremely important.
The older you are and the longer you have had diabetes, the more likely you are to have nerve damage.
People with diabetes who drink too much alcohol are also more likely to have nerve damage.
What are the symptoms of diabetic neuropathy?
The symptoms of diabetic neuropathy depend on which nerves are damaged. Patients may not feel pain, especially in the feet.
If pain or other problems are not treated, they can lead to serious infections.
If nerves in other parts of the body are damaged, the following symptoms may occur:
- Digestive problems. For example, flatulence, hiccups, constipation, nausea and vomiting, diarrhea, and abdominal pain.
- Body temperature problems. For example, heavy sweating at night or when eating certain foods. Some patients may have decreased sweating, especially in the legs and feet.
- Problems with urination. For example, it is difficult to tell if the bladder is full of urine or to empty the bladder completely.
- Sexual function problems. For example, erectile dysfunction in men or vaginal dryness in women.
- Cardiovascular problems, poor circulation or low blood pressure. This can lead to dizziness, weakness, or fainting when standing up or sitting up from a lying down position.
- Feeling sick when your blood sugar is low.
How is diabetic neuropathy diagnosed?
The doctor will check the patient’s sensation to light touch and temperature, and test for strength and response. Tests such as electromyography and nerve conduction function tests may be performed to confirm the diagnosis, and other tests will be needed to determine the type of neuropathy and help guide treatment.
Physicians cannot test for all types of nerve injury. Therefore, the patient needs to tell the doctor what the pain or weakness feels like. The doctor also needs to be told about heavy sweating or vertigo, and any changes in digestion, urination, and sexual function.
How is diabetic neuropathy treated?
The treatment is to keep blood glucose levels in the target range. This will not cure the nerve damage, but it may help prevent it from getting worse and reduce pain.
Other treatments depend on the symptoms:
- Medications are available to relieve pain.
- Medications are available to treat digestive or vascular problems.
- Blood pressure problems can be treated with medications or by wearing compression stockings (also called compression stockings).
- Use medications or devices to improve erections, or use lubricants to improve vaginal dryness.
- A contused nerve can be treated with a splint or stent.
If you have diabetes, you may have pain or other foot problems that go unnoticed, so check your feet daily. Untreated foot problems can lead to serious infections or even amputation. Ask your doctor what you can do to help improve your symptoms and work with him or her to find the most effective treatment.
How can I prevent diabetic neuropathy?
Keeping your blood glucose levels within the target range set by your doctor can help prevent neuropathy from occurring. The best way to do this is to check your blood sugar and adjust your treatment plan.
It’s also important to exercise, eat healthy, and maintain a healthy weight.