Diabetes and nerve damage

Definition

Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complication of diabetes.

Alternative Names

Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy

Causes

In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is more likely when the blood sugar level is not well controlled.

About one half of people with diabetes develop nerve damage. Symptoms often do not begin until many years after diabetes has been diagnosed. Some people who have diabetes that develops slowly already have nerve damage when they are first diagnosed.

People with diabetes are also at higher risk for other nerve problems not caused by their diabetes. These other nerve problems won't have the same symptoms and will progress in a different manner than nerve damage caused by diabetes.

Symptoms

Symptoms often develop slowly over many years. The types of symptoms you have depend on the nerves that are affected.

Nerves in the feet and legs are most often affected. Symptoms often start in the toes and feet, and include tingling or burning, or deep pain. Over time, nerve damage can also occur in the fingers and hands. As the damage gets worse, you will likely lose feeling in your feet and legs. Your skin will also become numb. Because of this, you may:

When the nerves that control digestion are affected, you may have trouble digesting food. This can make your diabetes harder to control. Damage to nerves that control digestion almost always occurs in people with severe nerve damage in their feet and legs. Symptoms of digestion problems include:

When nerves in your heart and blood vessels are damaged, you may:

Other symptoms of nerve damage are:

Exams and Tests

The health care provider will do a physical exam. The exam may find that you have the following:

Tests that may be ordered include:

Treatment

Follow your provider's advice on how to slow diabetic nerve damage.

Control your blood sugar (glucose) level by:

To treat the symptoms of nerve damage, your provider may prescribe medicines to treat:

When you have nerve damage in your feet, the feeling in your feet can be reduced. You can even have no feeling at all. As a result, your feet may not heal well if they are injured. Caring for your feet can prevent minor problems from becoming so serious that you end up in the hospital.

Caring for your feet includes:

Support Groups

Many resources can help you understand more about diabetes. You can also learn ways to manage your diabetic nerve disease

Outlook (Prognosis)

Treatment relieves pain and controls some symptoms.

Other problems that may develop include:

When to Contact a Medical Professional

Call your provider if you develop any symptoms of diabetic neuropathy.

References

American Diabetes Association. Standards of medical care in diabetes: 9. microvascular complications and foot care. Diabetes Care. 2016:39;Suppl 1:S72-S80. care.diabetesjournals.org/content/39/Supplement_1/S72.

Boulton AJM, Malik RA. Diabetes mellitus: neuropathy. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 53.

Katirji B. Disorders of peripheral nerves. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SK, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 107.



Review Date: 5/2/2016
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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