(Nerve Damage of Diabetes)
DefinitionDiabetic neuropathy is a type of nerve damage associated with diabetes. It results in damage to the nerves in a person’s feet, legs, and eyes, and to the nerves that control bodily functions, such as digestion, blood pressure, and heart rate.
|Nerves of the Foot|
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CausesDiabetic neuropathy is likely caused by a combination of factors, including:
- Metabolic problems such as high blood glucose
- Damage to blood vessels
- Autoimmune factors
Risk FactorsThis condition is more common in older adults. Factors that may increase your risk of diabetic neuropathy include:
- Having diabetes for 25 years or more
- Having type 2 diabetes
- High blood pressure
- Lifestyle factors such assmokingand alcohol use
- Lack of exercise
- Peripheral vascular disease
- High cholesterol
SymptomsSymptoms of diabetic neuropathy may include:
- Numbness , tingling, or pain in the extremities
- Weakness in arms and or legs
- Nausea or vomiting
- Diarrhea or constipation
- Urination problems
- Impotence or vaginal dryness
- Weakness of facial muscles resulting in drooping eyelid, drooping mouth, facial droop, difficulty swallowing
- Muscle cramps
- A prolonged feeling of fullness after eating, and/or abdominal pain
- Decreased ability to sweat normally
DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done. A foot exam will also be done. Your nerve function may be tested. This can be done with:
- Nerve conduction studies
- Quantitative sensory testing—the use of stimuli to check for neuropathy
- Quantitative sudomotor axon reflex test—a test to evaluate the nerve supply of sweat glands
TreatmentTalk with your doctor about the best treatment plan for you. Treatment options include:
Blood Glucose ManagementIt is important to regularly monitor blood glucose levels. You can bring them within normal range with meal planning, exercise, and/or medications.
Foot CareIf you have diabetic neuropathy, you will need to take special care of your feet. The nerves in the feet are the ones most often affected by neuropathy. This care will involve regular visits to a foot doctor and careful cleaning, inspection, moisturizing, and grooming of your feet. In addition, always wear well-fitting shoes and thick, soft, seamless socks to help protect your feet from injuries.
Other TreatmentsOther treatments will depend on your symptoms. Medications can be used to relieve pain, burning, tingling, or numbness. Often, the medications used to treat these symptoms are the same ones used to treat seizures and depression . Another option to treat pain is called transcutaneous electrical nerve stimulation (TENS). With TENS, a machine sends painless electrical signals through the skin to the nerves. Your doctor may offer this treatment.
PreventionThe best way to prevent diabetic neuropathy is to regularly monitor and manage your blood glucose levels. Your doctor can instruct you about how often to check your levels and what the numbers mean.
American Diabetes Association
National Diabetes Information Clearinghouse
Canadian Diabetes Association
American Academy of Neurology practice parameters for diagnostic testing for distal symmetric polyneuropathy. Neurology. December 3, 2008.
Diabetic neuropathies: the nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies.Updated November 26, 2013. Accessed September 19, 2014.
Diabetic peripheral neuropathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 12, 2014. Accessed September 19, 2014.
Ogawa K, Sasaki H, Yamasaki H, et al. Peripheral nerve functions may deteriorate parallel to the progression of microangiopathy in diabetic patients. Nutr Metab Cardiovasc Dis. 2006;16:313-321.
Types of peripheral neuropathy: pre-diabetic/diabetic University of Chicago, Center for Peripheral Neuropathy website. http://millercenter.uchicago.edu/learnaboutpn/typesofpn/diabetes/index.shtml. Accessed September 19, 2014.
Vinik AI. Diabetic neuropathies. Med Clin North Am. 2004;88:947-999.
2/4/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Dubinsky RM, Miyasaki J. Assessment: efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2010;74(2):173-176.
- Reviewer: Kim Carmichael, MD
- Review Date: 08/2014
- Update Date: 09/23/2014
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