What is the outlook for people with diabetic neuropathy?

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The outlook for people with diabetic neuropathy -- nerve damage -- depends on how well their diabetes is controlled. Treating the diabetes may stop the progression of the neuropathy and even improve symptoms slowly and gradually. Intense numbness, pain, or tingling in the feet or lower legs are the hallmark symptoms of diabetic neuropathy. These symptoms are caused by damage to the nerves from poor blood sugar control. Loss of sensation in the feet also increases the risk that foot injuries and infections may go unnoticed and untreated, and become serious. Treatment of diabetes-related foot problems involves first getting blood sugar levels under control and protecting the feet with daily foot checks and proper footwear. Sometimes diabetic neuropathy can cause problems in the eyes, digestive tract and bladder. The symptoms of diabetic neuropathy can sometimes be relieved by analgesics, anticonvulsants or low-dose antidepressants. Wearing support stockings, walking more often and taking warm baths may also help. Researchers are testing new medications for diabetic neuropathy.
The prognosis for diabetic neuropathy is based on the type of neuropathy.  As discussed in an earlier question, there are several type of diabetic neuropathy and listed below is the prognosis of each.  As a general rule, aggressive long term blood glucose control is the most important factors in slowing or halting the progression of diabetic neuropathy
1.  Sensorimotor polyneuropathy, which causes numbness, tingling and burning in the feet, worsens slowly over many years.  If diabetes is poorly controlled, it can ascend to involve the upper legs and hands and result in numbness and weakness in the feet making patients prone to falls, foot injury and ulcers.  In more severe cases such foot ulcers can become infected and lead to amputation.
2.  Autonomic neuropathy, which causes dizziness upon standing, constipation, trouble sweating, bladder dysfunction and erectile dysfunction, once present, progresses more rapidly than sensorimotor polyneuropathy.  The symptoms should be aggressively treated as it increases risk of developing heart attack, heart arhythmias and kidney failure.
3.  Truncal neuropathy, which causes numbness/tingling/pain in a patch of area over the trunk or abdomen, typically improves over several months.
4.  Proximal neuropathy, which causes pain and weakness of the upper part of the leg, improves over 1-2 years however less than 50% of patients recover completely.
5.  Cranial neuropathy, which causes problems with eye movement, recovers completely over weeks to months.
6.  Neuropathy secondary to compression such as carpal tunnel syndrome or ulnar neuropathy are treated in the same manner as in nondiabetics and in most cases respond well to treatment.      

The prognosis for diabetic neuropathy depends largely on how well the underlying condition of diabetes is handled. Treating diabetes may halt progression and improve symptoms of the neuropathy, but recovery is slow. The painful sensations of diabetic neuropathy may become severe enough to cause depression in some patients.

This answer is based on source information from the National Institute of Neurological Disorders and Stroke.

Continue Learning about Diabetic Neuropathy (Nerve Damage)

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