Nerve Damage (Neuropathy)

What are diabetic neuropathies?
Diabetic neuropathies are nerve disorders caused by diabetes. People with diabetes can, over a period of time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs leading to difficulties in digestion, sexual dysfunction, etc. About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, those with high levels of blood fat and blood pressure and those who are overweight.

Neuropathy Affects Nerves Throughout the Body

Peripheral neuropathy affects

  • Toes
  • Feet
  • Legs
  • Hands
  • Arms

Autonomic neuropathy affects

  • Heart and blood vessels
  • Digestive system
  • Urinary tract
  • Sex organs
  • Sweat glands
  • Eyes
  • Lungs

The symptoms of peripheral neuropathy include:

  • Numbness and loss of feeling (usually first in the feet or hands)
  • Pain varying from minor discomfort or tingling sensations in fingers and toes to severe pain. Pain may be sharp or lightning like, deep aches that make sleep or daily activities difficult or sensitive skin that responds 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 having an erection
  • Nausea or vomiting
  • Difficulty in swallowing
  • Constipation and diarrhea

How can I prevent diabetic neuropathies?

The best way to prevent neuropathy is to keep your blood glucose levels as close to the normal range as possible. Maintaining safe blood glucose levels protects nerves throughout your bod

Points To Remember

  • Diabetic neuropathies are nerve disorders caused by many of the abnormalities common to diabetes, such as high blood glucose.
  • Neuropathy can affect nerves throughout the body, causing numbness and sometimes pain in the hands, arms, feet or legs and problems with the digestive tract, heart, sex organs and other body systems.
  • Treatment first involves bringing blood glucose levels within the normal range. Good blood glucose control may help prevent or delay the onset of further problems.
  • Foot care is an important part of treatment. People with neuropathy need to inspect their feet daily for any injuries. Untreated injuries increase the risk of infected foot sores and amputation.
  • Treatment also includes pain relief and other medications as needed, depending on the type of nerve damage.
  • Smoking significantly increases the risk of foot problems and amputation. If you smoke, try quitting it.

Early recognition and management of neuropathy is important because 50% of neuropathies may be asymptomatic and therefore diabetics are at risk of getting insensate injury to their feet.

ADA recommends screening for the neuropathy at the diagnosis and once in a year every year, using simple clinical tests