What is diabetic neuropathy?

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Akash Bajaj, MD
Anesthesiology

Diabetic neuropathy, a common complication of diabetes, is damage to the nerves that allow you to feel sensations such as pain. There are a number of ways that diabetes affects the nerves, but they all seem related to blood sugar being too high for a long period of time.

Diabetes-related nerve damage can be painful, but it isn't severe pain in most cases.

There are four types of diabetic neuropathy: peripheral, autonomic, proximal, and focal.

In terms of treatment, it is very important to keep your blood sugar in a healthy range. You should learn the basic steps for managing your diabetes, avoiding its complications, and staying as healthy as possible. These steps will include diet, exercise, and sometimes medicines.

The following medications may be used to reduce symptoms in the feet, legs, and arms:

  • Certain drugs that are also used to treat depression, such as amitriptyline (Elavil), doxepin (Sinequan), or duloxetine (Cymbalta)
  • Certain drugs that are also used to treat seizures, such as gabapentin (Neurontin), pregabalin (Lyrica), carbamazepine (Tegretol), and valproate (Depakote)
  • Pain medicines

Extensive clinical experience supports the utility of SCS for the treatment of neuropathic pain. The development of new technologies will broaden the applications, improve the success rates, and further increase the acceptance of SCS for the treatment of intractable pain, including diabetic neuropathy.

Up to 70% of people with diabetes have some degree of damage to their nervous system, known as neuropathy. The damage can result in loss of feeling or pain in the hands or feet, slow digestion of food in the stomach, carpal tunnel syndrome, or other nerve problems. Mild cases may go completely unnoticed. Severe cases -- most likely involving the feet and lower limbs -- may lead to infections that require amputation. To keep neuropathy at bay, get a diabetes foot exam that tests your sensation every year.

Diabetic neuropathy is a nerve disorder caused by diabetes. It occurs when high blood sugar levels damage the walls of the tiny blood vessels that feed the nerves. Most often affected are nerves in the legs and feet. The result is numbness, tingling or intense pain. Because numbness in the feet makes it easy to overlook an injury, it increases the risk that a small wound or sore will become seriously infected. Diabetic neuropathy can also cause impotence, diarrhea or constipation, indigestion, lightheadedness and problems with bladder control.

About half or more of people with diabetes will develop neuropathy. It occurs most often in those with high blood sugar levels or who have had the disease for years.
Dr. Jack Merendino, MD
Endocrinology Diabetes & Metabolism
Diabetes is a common cause of neuropathy, or nerve damage, and we now know that significant nerve damage often develops in the pre-diabetic phase. There are many forms of neuropathy. The most common, peripheral neuropathy, causes tingling, numbness, and pain in the feet.
As the condition progresses, the symptoms may spread up the legs. The hands may be affected as well, usually after the symptoms in the legs and feet have become fairly severe. Numbness in the feet may mean that you don't feel when your feet are rubbing against your shoes, causing calluses or skin ulcers that can become infected. In severe cases, infection may spread to the underlying bone. This is often difficult to treat and may require prolonged antibiotic therapy.
Sometimes hospitalization is necessary, and if an infection is extremely resistant, surgery to remove infected bone or even amputation may be required. These very serious problems usually occur when a person has both neuropathy and poor circulation, so it's critical to prevent both problems by keeping blood sugar levels, blood pressure, and cholesterol under control.
The Best Life Guide to Managing Diabetes and Pre-Diabetes

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The Best Life Guide to Managing Diabetes and Pre-Diabetes

Bob Greene has helped millions of Americans become fit and healthy with his life-changing Best Life plan. Now, for the first time, Oprah's trusted expert on diet and fitness teams up with a leading...
Diabetic neuropathy is a term used to describe nerve injury or disease caused by diabetes.  Risk factors for developing diabetic neuropathy include age, duration of diabetes and poorly controlled diabetes (i.e. chronically elevated blood sugar levels). 
The most common type of diabetic neuropathy is diabetic polyneuropathy in which patients experiences numbness, tingling, prickly or burning sensations in the toes and feet.  In more severe cases it can be accompanied by unsteadiness when walking and weakness of the feet resulting in difficulty spreading the toes or bending the foot up at the ankle.  If diabetes remains poorly controlled, over time, the numbness and tingling can spread up the legs and also into the hands.  Another common type is diabetic autonomic neuropathy which causes dizziness upon standing, constipation, decreased sweating, bladder dysfunction and erectile dysfunction.  Other types of diabetic neuropathy include cranial neuropathy which can cause numbness of the face or inability to move the eye and truncal neuropathy which causes pain and numbness in a patch of are over the chest or abdomen.  Lastly, diabetics are also more prone to developing pressure related nerve injury such as carpal tunnel syndrome which is a pinched nerve at the wrist causing numbness and tingling in the fingers or ulnar neuropathy at the elbow causing numbness and tingling the inner side of the forearm and ring finger and pinky.     
William D. Knopf, MD
Cardiology (Cardiovascular Disease)
There are many different types of neuropathy, or nerve damage, and each type affects different nerve groups. Peripheral neuropathy affects the nerves that lead to the arms and legs. Diabetic peripheral neuropathy is the most common type of diabetifc neuropathy and usually takes a long period of time to develop. At least 50 percent of all people with diabetes develop some type of neuropathy.
 
There are many different types of neuropathy, or nerve damage, and each type affects different nerve groups. Peripheral neuropathy affects the nerves that lead to the arms and legs. Diabetic peripheral neuropathy is the most common type of diabetifc neuropathy and usually takes a long period of time to develop. At least 50 percent of all people with diabetes develop some type of neuropathy.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.