Diabetic neuropathy, a common complication of diabetes, is damage to the nerves that allow you to feel things such as pain. There are several ways that diabetes damages 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.
If you're one of the nearly 24 million Americans living with type 2 diabetes, you know your body has difficulty using or producing insulin. What can you do to manage the disease? We asked Jill Crandall, MD, professor of clinical medicine and director of the diabetes clinical trials unit at Albert Einstein College of Medicine in New York City, to debunk some myths and help you learn to live well.
There are four types of diabetic neuropathy: peripheral, autonomic, proximal, and focal.
Diabetic Peripheral Neuropathy
The areas of the body most commonly affected by diabetic peripheral neuropathy are the feet and legs. Nerve damage in the feet can result in a loss of foot sensation, increasing your risk of foot problems. Injuries and sores on the feet may go unrecognized due to lack of sensation. Therefore, you should practice proper skin and foot care. Rarely, other areas of the body such as the arms, abdomen, and back may be affected.
Symptoms of diabetic peripheral neuropathy may include:
Numbness (severe or long-term numbness can become permanent)
Burning (especially in the evening)
In most cases, early symptoms of diabetic peripheral neuropathy will become less when blood sugar is under control. Medications can be taken to help control the discomfort if needed.
To prevent peripheral neuropathy:
Work with your doctor to keep your blood sugar under tight control
To help prevent the complications of peripheral neuropathy:
Examine your feet and legs daily.
Apply lotion if your feet are dry.
Care for your nails regularly (Go to a podiatrist, if necessary).
Wear properly fitting footwear and wear them all the time to prevent foot injury.
Diabetic Autonomic Neuropathy
Diabetic autonomic neuropathy most often affects the digestive system, especially the stomach, blood vessels, urinary system, and sex organs. To prevent autonomic neuropathy, keep your blood sugar levels well controlled.
Symptoms of diabetic autonomic neuropathy of the digestive system may include:
Feeling full after small meals
Treatments of autonomic neuropathy of the digestive system may include:
Eating smaller meals
Symptoms of diabetic autonomic neuropathy of the blood vessels may include:
Blacking out when you stand up quickly
Increased heart rate
Low blood pressure
Treatments of autonomic neuropathy of the blood vessels may include:
Avoid standing up too quickly
Wearing special stockings
Symptoms of autonomic neuropathy of the male sex organs may include:
Unable to have or maintain an erection (erectile dysfunction)
"Dry" or reduced ejaculations
Note:Impotence needs to be evaluated by your doctor. It may be caused by your medicines or something other than diabetes.
Treatments of autonomic neuropathy of the male sex organs include:
Vacuum erection device
Symptoms of autonomic neuropathy of the female sex organs may include:
Decrease in vaginal lubrication
Decrease in number of orgasms or lack of orgasm
Treatments of autonomic neuropathy of the female sex organs include:
Vaginal estrogen creams, suppositories, and rings
Medications to help reduce the symptoms of painful sex due to menopause
Symptoms of autonomic neuropathy of the urinary system may include:
Unable to completely empty bladder
Incontinence (leaking urine)
Increased urination at night
Treatments of autonomic neuropathy of the urinary system include:
Self-catheterization (inserting a catheter into the bladder to release urine)