Diabetic Neuropathy

Definition

Diabetic neuropathy is a type of nerve damage associated with diabetes. It results in damage to the nerves in a person’s feet, legs, and eyes, and to the nerves that control bodily functions, such as digestion, blood pressure, and heart rate. Diabetic neuropathy can lead to serious complications, including ulcers, infection, and limb loss.

Nerves of the Foot

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Causes

Researchers believe that diabetic neuropathy is likely caused by a combination of factors, including:

• Metabolic problems (eg, high blood glucose)
• Damage to blood vessels
• Autoimmune factors
• Genetics
• Lifestyle factors (eg, smoking, alcohol use, high blood pressure)

Risk Factors

The following factors are thought to increase the risk of diabetic neuropathy:

• Older age
• Having diabetes for 25 years or more
• Having type 2 diabetes
• High blood pressure
• Smoking
• Obesity
• Lack of exercise
• Peripheral vascular disease
• High cholesterol

Symptoms

Symptoms of diabetic neuropathy may include:

• Numbness in the extremities
• Tingling in the extremities
• Pain in the extremities
• Wasting of the muscles of the feet or hands
• Indigestion
• Nausea or vomiting
• Diarrhea or constipation
• Dizziness or fainting
• Urination problems
• Impotence or vaginal dryness
• Weakness in arms and or legs
• Foot drop
• Weakness of facial muscles resulting in drooping eyelid, drooping mouth, facial droop, difficulty swallowing
• Muscle cramps
• A prolonged feeling of fullness after eating, and/or abdominal pain
• Heat intolerance due to a decreased ability to sweat normally

If you have diabetic neuropathy, you are at increased risk for developing other types of neuropathies, such as carpal tunnel syndrome.

Diagnosis

Your doctor will ask about your symptoms and medical history. He will also do a physical exam. Other tests may include:

• Foot exam—to assess sensation in the foot
• Nerve conduction studies —to test nerve activity
• Electromyography —to determine how muscles respond to nerve signals
• Quantitative sensory testing—the use of stimuli (eg, vibration) to check for neuropathy
• Quantitative sudomotor axon reflex test—a test to evaluate the nerve supply of sweat glands
• Heart rate tests—to determine how the heart responds to changes
• Ultrasound—a test that uses sound waves to view internal organs
• Biopsy —to remove a sample of nerve or skin tissue for examination

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Prevention

The best way to prevent diabetic neuropathy is to regularly monitor and manage your blood glucose levels. Your doctor can instruct you about how often to check your levels and what the numbers mean.