Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can seriously injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet. Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For a wide variety of people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal. Diabetic neuropathy is a common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.
There are four main types of neuropathy, and they are:
- Peripheral neuropathy, which affects the feet and hands, is the most common form of diabetic neuropathy
- Autonomic neuropathy, affecting the nerves that control the involuntary functions of the body, like digestion
- Proximal neuropathy, which affects the legs
- Focal neuropathy, in which damage can occur in any nerve or any group of nerves.
The symptoms and signs of diabetic neuropathy depend on the type of neuropathy that is present. Signs and symptoms can also vary in severity among affected people.Signs and symptoms of diabetic peripheral neuropathy include:
- Numbness or tingling of the feet and lower legs
- Pain or burning sensations
- Loss of sensation in the feet or lower legs
- Signs and symptoms of diabetic proximal neuropathy include:
- Pain, usually on one side, in the hips, buttocks, or thighs
- Weakness of the legs
Signs and symptoms of diabetic autonomic neuropathy depend upon the organ system that is involved and can include:
- Nausea and/or vomiting
- Erectile dysfunction in men
The exact effect of blood sugar on the nervous system is still unknown. However, prolonged exposure to higher than normal glucose damages the nerves, causing neuropathy. High levels of triglycerides, a key blood fat are also associated with the development of nerve damage.
A physician will carry out a physical exam and do a foot exam to check for:
- Ankle reflexes
- Loss of sensation
- Changes in skin color
Other tests may include an ultrasound of affected organs or a check of blood pressure or heart rate variability.
When to see a doctor
Seek medical care if you notice:
- A cut or sore on your foot that doesn't seem to be healing, is infected or is getting worse
- Burning, tingling, weakness or pain in your hands or feet
- Changes in your digestion, urination or sexual function
While diabetic neuropathy cannot be cured, there are some treatments available to help manage some of the symptoms. Another treatment goal is keeping blood glucose under good control through a mix of diet and medication so that the neuropathy does not worsen. Keeping blood glucose levels under control has been shown to improve symptoms and prevent worsening of the pain.
To prevent the complications of diabetic peripheral neuropathy, good foot care is needed. People with the condition should inspect their feet every day for injuries or sores. Smoking increases the risk of foot problems. A podiatrist can help with foot care, and a health care provider can give advice on quitting smoking.Make sure to follow these tips in order to avoid this nerve damage.