Definition

Diabetic neuropathy is a type of nerve damage associated with diabetes. It results in damage to a person’s feet, legs, eyes, and bodily functions. Diabetic neuropathy can lead to serious complications. See your doctor if you suspect you have this condition.

Nerves of the Foot

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Causes

Researchers believe that diabetic neuropathy is likely caused by a combination of factors, including:

• Metabolic problems (eg, high blood glucose)
• Damage to blood vessels
• Autoimmune factors
• Genetics
• Lifestyle factors (eg, smoking, alcohol use, high blood pressure)

Risk Factors

The following factors are thought to increase the risk of diabetic neuropathy:

• Older age
• Having diabetes for 25 years or more
• Having type 2 diabetes
• High blood pressure
• Smoking
• Obesity
• Lack of exercise
• Peripheral vascular disease
• High cholesterol

Symptoms

Symptoms of diabetic neuropathy may include:

• Numbness in the extremities
• Tingling in the extremities
• Pain in the extremities
• Wasting of the muscles of the feet or hands
• Indigestion
• Nausea or vomiting
• Diarrhea or constipation
• Dizziness or faintness
• Urination problems
• Impotence or vaginal dryness
• Weakness in arms and or legs.
• Weakness of facial muscles resulting in:
  • Drooping eyelid
  • Drooping mouth
  • Facial Droop
  • Difficulty swallowing.
• Muscle Cramps

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Other tests may include:

• Foot exam—to assess sensation in the foot
• Nerve conduction studies—to test nerve activity
• Electromyography—to determine how muscles respond to nerve signals
• Quantitative sensory testing—the use of stimuli (eg, vibration) to check for neuropathy
• QSART (quantitative sudomotor axon reflex test) a test which evaluates the inervation of sweat glands.
• Heart rate tests—to determine how the heart responds to changes
• Ultrasound—to view internal organs
• Biopsy—to remove a sample of nerve or skin tissue for examination

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Other treatments will depend on your symptoms. Medications can be used to relieve pain, burning, tingling, or numbness. Oftentimes, the medications used to treat these symptoms are the same types of medications used to treat seizures and depression. Modifying your diet and/or taking erythromycin or another antibiotic can help with gastrointestinal problems. Taking care when sitting or standing, increasing salt intake, or taking medications can help manage dizziness and weakness. An antibiotic can be prescribed to treat a urinary tract infection. Medications can be used to treat erectile dysfunction, and vaginal lubricants are recommended to treat vaginal dryness.

Prevention

The 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.