Definition
Diabetic 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. Diabetic neuropathy can lead to serious complications, including ulcers, infection, and limb loss.
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 fainting
- Urination problems
- Impotence or vaginal dryness
- Weakness in arms and or legs
- Foot drop
- 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
- Heat intolerance due to a decreased ability to sweat normally
If you have diabetic neuropathy, you are at increased risk for developing other types of neuropathies, such as carpal tunnel syndrome.
Diagnosis
Your doctor will ask about your symptoms and medical history. He will also do 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
- Quantitative sudomotor axon reflex test—a test to evaluate the nerve supply of sweat glands
- Heart rate tests—to determine how the heart responds to changes
- Ultrasound—a test that uses sound waves 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:
Blood Glucose Management
It is important to regularly monitor blood glucose levels. You can bring them within normal range with meal planning, exercise, and/or medicines.
Foot Care
If 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 Treatments
Other treatments will depend on your symptoms. Medicines can be used to relieve pain, burning, tingling, or numbness. Often, the medicines 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.
If you have gastrointestinal problems, modifying your diet and/or taking an antibiotic can help. Taking care when sitting or standing, increasing salt intake, or taking medicines can help manage dizziness and weakness. An antibiotic can be prescribed to treat a urinary tract infection. Medicines 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.
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