Preventing Diabetes Problems
Diabetic neuropathy is nerve damage that can occur in people with diabetes. Different types of nerve damage cause different symptoms. Symptoms can range from pain and numbness in your feet to problems with the functions of your internal organs, such as your heart and bladder.
What Is Diabetic Neuropathy?Diabetic neuropathy is nerve damage that is caused by diabetes. Over time, high blood glucose levels, also called blood sugar, and high levels of fats, such as triglycerides, in the blood from diabetes can damage your nerves. Symptoms depend on which type of diabetic neuropathy you have. Peripheral NeuropathyPeripheral neuropathy is a type of nerve damage that typically affects the feet and legs and sometimes affects the hands and arms. This type of neuropathy is very common. About one-third to one-half of people with diabetes have peripheral neuropathy. Autonomic NeuropathyAutonomic neuropathy is damage to nerves that control your internal organs, leading to problems with your heart rate and blood pressure, digestive system, bladder, sex organs, sweat glands, and eyes. The damage can also lead to hypoglycemia unawareness. Focal NeuropathiesFocal neuropathies are conditions in which you typically have damage to single nerves, most often in your hand, head, torso, or leg. The most common types of focal neuropathy are entrapment syndromes, such as carpal tunnel syndrome. Other types of focal neuropathy are much less common. Proximal NeuropathyProximal neuropathy is a rare and disabling type of nerve damage in your hip, buttock, or thigh. The damage typically affects one side of your body and may rarely spread to the other side. Symptoms gradually improve over a period of months or years. Related Conditions & DiseasesAdditional LanguagesThis content is also available in:
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the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: What is diabetic neuropathy?Neuropathy is a complication of diabetes that can lead to problems throughout the body. Diabetes can affect nerves that control movement, sensation and other functions. If you have diabetes, you can develop nerve problems at any time. Sometimes, neuropathy can be the first sign of diabetes. Significant nerve problems (clinical neuropathy) can develop within the first 10 years after a diabetes diagnosis. The risk of developing neuropathy increases the longer you have diabetes. About half of people with diabetes have some form of neuropathy. What causes diabetic neuropathy?Although the exact causes of diabetic neuropathy are unknown, several factors may contribute to the disorder, including:
What are the symptoms and types of diabetic neuropathy?The symptoms of diabetic neuropathy depend on the type of neuropathy and on which and how many nerves are affected. Focal Neuropathy (Diabetic Mononeuropathy)This type of diabetic neuropathy affects one nerve at a time, and the symptoms depend on which nerve is affected. For example, it can affect nerves in the chest (thoracic nerves) and cause numbness and pain in the chest wall that mimics angina, heart attack or appendicitis. Other types of focal neuropathy can cause:
Diabetic PolyneuropathyDiabetic polyneuropathy (DPN) affects multiple peripheral sensory and motor nerves that branch out from the spinal cord into the arms, hands, legs and feet. Typically, the longest nerves — those that extend from the spine to the feet — are affected the most. DPN can cause:
Because it inhibits the ability to sense problems, DPN can put a person at risk for injuries of the feet and toes, and lead to the development of ulcers, wounds and chronic infections in the feet. Some mild cases of DPN may go unnoticed for years, but worsening nerve damage can cause severe pain and make the simplest of daily activities — such as sleeping or walking — extremely uncomfortable. If left untreated, DPN can result in further nerve damage to other parts of the body, such as the eyes, digestive tract and sexual organs. It also is the primary cause of amputations, resulting in nearly one case every five-and-a-half minutes in the United States. DPN has two distinct types: diabetic autonomic neuropathy and proximal neuropathy. Diabetic Autonomic NeuropathyDiabetic autonomic neuropathy primarily affects the autonomic nerves that serve internal organs, processes, and systems of the heart, digestive system, sexual organs, urinary tract and sweat glands. This kind of diabetic polyneuropathy can cause symptoms such as:
Proximal Neuropathy (Diabetic Amyotrophy)Proximal neuropathy is known by many names, and is a relatively rare type of diabetic neuropathy that occurs in about 1% of patients with type 2 diabetes. It tends to affect older adults, and can strike those with recently diagnosed or well-controlled diabetes. The main symptom is nerve pain that starts in the upper thigh of one leg and can involve the hip and lower back. Weight loss is a symptom in about 35% of patients with proximal neuropathy, and about 18% experience weakness in the affected area in addition to the pain. Rarely, proximal neuropathy can occur in the arm. As the condition progresses over months, the pain can spread to involve the upper and lower parts of both legs. After several months, symptoms tend to ease up, but patients can be left with lasting disability, including foot drop and recurrence of symptoms. The symptoms of diabetic neuropathy may resemble other conditions or medical problems. Always consult your doctor for a diagnosis. How is diabetic neuropathy diagnosed?Early diagnosis of diabetic neuropathy gives patients the best chance of effective treatment. But since not all foot or limb pain means diabetic neuropathy, accurate diagnosis is important to ensure appropriate treatment. Diagnosis of diabetic neuropathies is based on history, clinical examination and supporting laboratory tests. Your doctor may:
A comprehensive evaluation — including a review of blood pressure, cholesterol and blood glucose screenings — combined with more advanced screening, helps the doctor rule out other causes and identify the core problem. What is the treatment for diabetic neuropathy?Treatment of diabetic neuropathies consists of two stages: using lifestyle changes and sometimes medications to achieve optimal diabetic control, and symptomatic control of pain and other complications. Controlling Blood Glucose LevelsGetting blood glucose levels under control can’t reverse nerve damage but can prevent further damage from occurring. Your doctor will give you specific blood sugar goals. Managing these levels includes eating a healthy diet high in protein and low in carbs. When you eat carbs, try to choose food with a higher fiber content, avoiding chips and soda. Regular exercise can help keep blood sugar levels manageable by increasing insulin sensitivity, meaning you’ll need to take less insulin each day. Getting enough sleep is also important, as we often crave high-carb foods when overly tired. Improving Other Risk FactorsAlthough getting blood glucose under control is important, it might not be enough. It is also important to control other risk factors such as high triglycerides or cholesterol, treat high blood pressure and quit smoking. Daily aerobic exercises are shown to protect the nerves and improve neuropathy outcomes. Losing weight is also important if a patient is obese or overweight. Managing Pain and Other ComplicationsDiabetic neuropathy can cause chronic pain and complications such as gastrointestinal problems, dizziness and weakness, and urinary or sexual problems. There are a variety of treatments that can help, including:
Treatment will vary depending on your specific symptoms and the severity of your neuropathy. It is also important to check your feet daily for problems such as ingrown toenails, blisters and sores, especially if you have peripheral neuropathy. Because of the numbness associated with neuropathy, you may not feel these conditions develop. Keeping your feet clean and covered can help protect them from injury and prevent further complications such as infections. Where does diabetic nerve pain usually start?Peripheral nerve damage affects your hands, feet, legs, and arms, and it's the most common type of nerve damage for people with diabetes. It generally starts in the feet, usually in both feet at once. Other symptoms may include: Pain or increased sensitivity, especially at night.
What does it feel like to have diabetic nerve pain?Tingling or burning feeling. Sharp pains or cramps. Muscle weakness. Extreme sensitivity to touch — for some people, even a bedsheet's weight can be painful.
How do you stop diabetic nerve pain?For diabetic neuropathy, you may want to try:. Capsaicin. Capsaicin cream, applied to the skin, can reduce pain sensations in some people. ... . Alpha-lipoic acid. ... . Acetyl-L-carnitine. ... . Transcutaneous electrical nerve stimulation (TENS). ... . Acupuncture.. What are the three most common symptoms of diabetic neuropathy?If you have diabetes and notice numbness, tingling, pain, or weakness in your hands or feet, you should see your doctor. These are early symptoms of peripheral neuropathy. The danger is usually when you can't feel pain and an ulcer develops on your foot.
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