Diabetes: Nerve Damage (Neuropathy)

What is diabetic neuropathy?

Diabetic neuropathy is nerve damage caused by diabetes.

The most common form of diabetic neuropathy is loss of feeling in the hands and feet. It is called peripheral neuropathy.

Diabetic neuropathy can also affect the nerves that control body functions such as heart rate and digestion. This type of problem is called autonomic neuropathy.

How does it occur?

Doctors have been studying diabetic neuropathy for many years, but they do not yet understand how diabetes damages the nervous system. However, they do know that good control of blood sugar levels helps prevent diabetic neuropathy.

What are the symptoms?

You can have peripheral neuropathy and not notice any symptoms. If you do have symptoms, they may include:

• loss of feeling (usually first in the feet or hands)
• slower reflexes
• pain ranging from minor discomfort or tingling in fingers and toes to severe pain
• pain that is sharp or lightninglike
• pain that is a deep ache that makes sleep or daily activities difficult
• painful sensitivity to the slightest touch
• weak muscles.

The symptoms of autonomic neuropathy include:

• low blood pressure and dizziness when you rise quickly from sitting or lying down
• rapid or irregular heartbeats
• trouble emptying the bladder
• constipation or diarrhea
• nausea or vomiting
• trouble swallowing
• trouble having an erection.

How is it treated?

There is no cure for neuropathy. The best approach is to prevent it by controlling your blood sugar.

Muscle weakness is treated with support, such as splints. Physical therapy can also help with exercises for the weak muscles. Exercises can be also used to strengthen other muscles that have not weakened.

Pain-killing drugs or cream applied to the skin may help pain during the night. Medicines can be used to treat nausea, vomiting, and diarrhea.

If you have diabetic neuropathy, injuries are a serious problem because you can't feel if something is hot or sharp. Diabetes also makes it harder for injuries to heal. It is very important to be extra careful to avoid burns, cuts, and other injuries.

How long will the effects last?

The neuropathy will continue once you have it. However, you may be able to stop it from getting worse by keeping your blood sugar under good control.

How can I take care of myself?

Neuropathy makes other diabetes-related complications worse. For example, if you have lost feeling in your feet and legs, you may not know you have an injury or infection until it develops into a bad sore. Make sure you:

• Look for injuries on the skin of your feet and lower legs daily.
• See your provider promptly if you have redness, bumps, blisters, or sores on your skin so they can be treated properly.
• See your healthcare provider or a podiatrist about corns or calluses on your feet.
• Ask your provider about how to trim your toenails properly.
• Wear good-fitting, comfortable shoes that protect your feet.

Men who have trouble having erections, which is a condition called erectile dysfunction (ED) or impotence, should talk to their healthcare providers. There are medicines to help a man get and maintain an erection. There are also mechanical devices to help. Ask your provider if your problem is related to the diabetes and what might be done about it. Urologists are the medical specialists who usually help with ED.

How can I help prevent diabetic neuropathy?

The best way to help prevent diabetic neuropathy is to:

• Control your diabetes. Try to keep your blood sugar at a normal level.
• Do not smoke. Smoking damages blood vessels, which makes skin infections more likely.
• Keep your blood pressure at a normal level.
• Exercise regularly, according to your healthcare provider's recommendation.
• Limit the amount of alcohol you drink because alcohol can cause neuropathy too.
• Eat a healthy diet with fruits and vegetables (some vitamin deficiencies can cause neuropathy).
• Keep your checkup appointments with your healthcare provider.

For more information contact:

• American Diabetes Association, Inc.
  Phone: 800-DIABETES, or 800-342-2383
  Web site: http://www.diabetes.org