Diabetic-Neuropathy

Overview

Diabetic neuropathy is nerve damage resulting from diabetes. High blood sugar can injure nerve fibers throughout your body, but with diabetic neuropathy, most often the nerves in your legs and feet are damaged. Diabetic neuropathy is a serious and common complication of diabetes.

Causes

Nerve fibers can become damaged with prolonged exposure to high blood sugar causing diabetic neuropathy. It is not entirely known why this occurs, but a combination of factors likely plays a role.

Factors include:

  • Complex interaction between nerves and blood vessels. High blood sugar interferes with the ability of nerves to transmit signals and weakens the walls of the small blood vessels that supply the nerves with oxygen and nutrients.
  • Inflammation in the nerves caused by an autoimmune response. An autoimmune response occurs when your immune system mistakenly attacks part of your body as if it were a foreign organism.
  • Genetic factors. Some people are more susceptible to nerve damage than others.
  • Smoking and alcohol abuse. This causes damage to both nerves and blood vessels and significantly increases your risk of getting infections.

Symptoms

Symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, blood vessels, heart and urinary tract. The symptoms can be mild for some people, and for others diabetic neuropathy can be painful, disabling and even fatal.

There are four types of diabetic neuropathy: Peripheral neuropathy, autonomic neuropathy, radiculoplexus neuropathy and mononeuropathy. People can have symptoms from one or several types of diabetic neuropathy. In most cases, the symptoms develop gradually and many do not notice any problems until considerable damage has been done.

Peripheral Neuropathy

Peripheral neuropathy is the most common type of diabetic neuropathy. Usually your feet and legs are affected first, followed by your hands and arms.
Symptoms include:

  • Numbness or reduced ability to feel pain or changes in temperature especially in your feet and toes
  • A tingling or burning feeling
  • Sharp, jabbing pain that may be worse at night
  • Pain when walking
  • Extreme sensitivity to the lightest touch
  • Muscle weakness and difficulty walking
  • Foot problems such as ulcers, infections, deformities and bone and joint pain

Autonomic Neuropathy

Diabetic neuropathy can affect the nerves in any of the autonomic nervous system – heart, bladder, lungs, stomach, intestines, sex organs and eyes. Symptoms include:

  • A lack of awareness that your blood sugar levels are low
  • Bladder problems such as frequent urinary tract infections and urinary incontinence
  • Constipation and uncontrolled diarrhea
  • Gastroparesis (slow stomach emptying) which leads to nausea, vomiting and loss of appetite
  • Difficulty swallowing
  • In men, erectile dysfunction
  • In women, vaginal dryness and other sexual difficulties
  • Decreased or increased sweating
  • The inability for your body to adjust blood pressure and heart rate which leads to sharp drops in blood pressure when rising from sitting or lying down
  • Problems with regulating your body temperature
  • Changes to how your eyes adjust from light to dark
  • Increased heart rate when you are at rest

Radiculoplexus Neuropathy

Radiculoplexus neuropathy affects the nerves in the thighs, hips, buttocks or legs. This condition is more common in people with type 2 diabetes and older adults. Symptoms are usually on only one side of the body, but can spread to the other side in some cases. Symptoms include:

  • Sudden, severe pain in your hip, thigh or buttock
  • Weak thigh muscles
  • Difficulty rising from a sitting position
  • Abdominal swelling (if the abdomen is affected)
  • Weight loss

Mononeuropathy

Mononeuropathy affects a specific nerve. The nerve may be in the face, torso or leg. Mononeuropathy is most common in older adults. Mononeuropathy can cause severe pain, but usually does not cause any long-term problems. Over a few weeks or months the symptoms usually diminish and disappear on their own. Symptoms include:

  • Difficulty focusing your eyes, double vision or aching behind one eye
  • Bell’s palsy (paralysis on one side of your face)
  • Pain in your shin or foot, or the front of your thigh
  • Chest or abdominal pain

Treatment

There is no known cure for diabetic neuropathy. Diabetic neuropathy clinical trials focus on slowing the progression of the disease, relieving pain, managing complications and restori