Medically Reviewed By: Tom Iarocci, MD
People with diabetes can develop many different complications over the years, and one very common one is known as diabetic neuropathy, which is essentially nerve damage. Neuropathies are a group of different disorders that involve the nerves in different ways, and sometimes no symptoms are present at first. Other times, neuropathy will lead to symptoms such as numbness tingling or pain in the fingers, toes, legs, feet, hands and arms. There can also be muscle weakness as a result of some types of neuropathy. If the neuropathy develops in a part of the nervous system that deals with the internal organs, symptoms can arise in the stomach organs, heart, and genitourinary system. Most of the time, more than one nerve is involved, so it’s called a polyneuropathy. Diabetic polyneuropathy is the most common neuropathy in the Western world. One of the major potential impacts is loss of sensation in the feet and recurrent foot infections.
Cause And Explanation Of Diabetic Neuropathy:
The precise cause is unknown, but a combination of factors, with high blood glucose topping the list, is thought to be involved. The majority of people with diabetes will develop some type of neuropathy, according to statistics from the National Institutes of Health; however, there may not always be symptoms. Risks do increase with age and the length of time that diabetes has been present, and the highest neuropathy rates occur in those who have been diabetic for 25 years or longer. Neuropathy is also more common in those who have had difficulty controlling their blood glucose levels.
Symptoms Of Diabetic Neuropathy:
The symptoms of diabetic neuropathy vary depending on the particular nerves involved. Sometimes there are no symptoms at all, while in other cases people will commonly have tingling, pain, and/or numbness. These symptoms, if you do encounter them, can begin in a very minor way, and then progress over time. For some people with diabetes, this could continue on for years unnoticed. When the nerves of the autonomic nervous system (a particular branch of the nervous system) are involved, this is known as diabetic autonomic neuropathy and symptoms may involve the digestive system with indigestion, diarrhea; the cardiovascular system with dizziness; the genitourinary system with bladder problems and erectile dysfunction; as well as other organs and symptoms.
Preventing Diabetic Neuropathy:
The American Diabetes Association recommends screening for diabetic autonomic neuropathy at the time of diagnosis of type 2 diabetes and five years after the diagnosis of type 1 diabetes. Unfortunately, there is no cure for diabetic neuropathy once symptoms have set in. That is why knowing you are diabetic is such an important part of prevention. In a well-known trial of people with type 1 diabetes, good blood glucose control, intensive therapy with insulin, was found to reduce cardiovascular diabetic neuropathy by 53 percent. Once the nerve damage occurs in diabetic peripheral neuropathy, it is usually irreversible, although keeping your blood glucose levels well controlled can help prevent additional damage, which can be quite important.
If you have diabetes, the best way to prevent diabetic neuropathy is to consistently maintain healthy blood glucose levels: visit your doctor regularly, follow a dietary plan, do your self monitoring and take your medications as prescribed. Meet your blood glucose targets.
Getting enough sleep, eating right, and taking care of your body are also extremely important steps to take for all of us, and especially those of us who have diabetes. Your doctor can help you check on any symptoms you think might be related to diabetic neuropathy. Painful diabetic neuropathy is a strong predictor of depression, so make sure you talk to your doctor about your whole situation and all of your symptoms, and not just your foot pain, for instance.