Diabetic Neuropathy (Nerve Problems)
What is diabetic neuropathy?
Diabetic neuropathy, a nerve disorder, is a complication of diabetes that can lead to problems throughout your body.
If you have diabetes, you can develop nerve problems at any time. Significant nerve problems, or clinical neuropathy, can develop within the first 10 years after receiving 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 the following:
High blood glucose. High blood glucose causes chemical changes in nerves and impairs the nerves' ability to transmit signals. It also has the potential to damage blood vessels that carry oxygen and nutrients to the nerves.
Inherited factors. There are some genetic traits that may make some people more susceptible to nerve disease than others.
What are the symptoms of diabetic neuropathy?
The following are the most common symptoms of diabetic neuropathy. However, each individual may experience symptoms differently. Symptoms include:
Numbness in the hands or feet
Pain in the hands, feet, or legs
Problems with internal organs, such as the digestive tract, heart, or sexual organs causing the following:
Indigestion
Diarrhea or constipation
Dizziness
Bladder infections
Impotence
Weakness
Weight loss
Depression
The symptoms of diabetic neuropathy may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
What are the different types of diabetic neuropathy?
Diffuse neuropathy is neuropathy that affects many parts of the body, and includes the following:
Diffuse peripheral neuropathy. Neuropathy affecting nerves in the extremities (legs, feet, arms, and hands).
Symptoms include:Numbness
Tingling, burning, or prickling
Sharp pains or cramps
Extreme sensitivity to touch
Loss of balance or coordination
Insensitivity to pain or temperature changes
Diffuse autonomic neuropathy. Neuropathy that affects nerves that serve internal organs, processes, and systems of the heart, digestive system, sexual organs, urinary tract, and sweat glands.
Symptoms include:Incontinence
Digestive problems
Low blood pressure
Dizziness
Fainting
Impaired perception of pain
Hypoglycemia
Profuse sweating
Focal neuropathy. Neuropathy that affects a single, specific nerve and part of the body, such as the eyes, facial muscles, hearing, pelvis and lower back, thighs, and abdomen.
Symptoms include:Pain in the thighs
Severe pain in lower back or pelvis
Pain in the chest, stomach, or flank
Chest or abdominal pain that mimics angina, heart attack, or appendicitis
Aching behind the eyes
Inability to focus the eyes
Double vision
Paralysis on one side of the face
Hearing problems
How is neuropathy diagnosed?
In addition to a complete medical history and physical examination, the doctor may:
Check muscle strength
Check muscle reflexes
Check muscle sensitivity to the following:
Position
Vibration
Temperature
Light touch
Request additional tests, such as:
Nerve conduction studies (to check flow of electrical current through a nerve)
Electromyography (to determine how muscles respond to electrical impulses)
Ultrasound (to determine how parts of the urinary tract are functioning)
Nerve biopsy (to remove a sample of nerve for examination)
What is the treatment for neuropathy?
Your doctor will determine specific treatment for your neuropathy, based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
The goal of treatment is to relieve pain and discomfort, as well as to prevent additional tissue damage. Treatment may include:
Pain medications
Antidepressant medications
Topical creams
Transcutaneous electronic nerve stimulation (TENS) therapy
Hypnosis
Relaxation training
Biofeedback training
Acupuncture
Treatment may also be prescribed for complications of neuropathy, such as gastrointestinal problems, dizziness and weakness, and urinary or sexual problems.