Reviewed by: Steven Chessler, M.D., Ph.D. 5/18.
The nerves in our body are very important to our health and play significant roles in the body. Nerves carry messages between our brain and every other part of our body, making it possible for us to hear, see, feel and move.
Nerves are also responsible for carrying messages to other vital parts of our body like the lungs and heart. Damage to the nerves as a result of diabetes complications is called diabetic neuropathy.
High levels of sugar in the blood – which is the situation in diabetes – can interfere with the nerve’s ability to transmit signals. It damages the small blood vessels supplying the nerves with oxygen and nutrients, leading to the damage or disappearance of the nerves.
Even though high blood glucose level can damage nerve fibers throughout the body, diabetic neuropathy is mostly observed to cause damage to nerves in the legs and feet.
Symptoms of diabetic neuropathy can vary depending on the affected nerves and can range from pain and numbness in your extremities to problems with the urinary tract, digestive tract, blood vessels and the heart.
While these symptoms can be mild for some individuals, it can be very painful, fatal and disabling in some people. Keeping close control of your blood sugar level and living a healthy lifestyle are good ways to prevent or slow down the manifestations of diabetic neuropathy.
What Are the Causes and Risk Factors of Diabetic Neuropathy?
- Prolonged exposure to high blood sugar levels directly damages the nerves and also causes the walls of the small blood vessels that supply oxygen and nutrients to the nerves to become weakened and thus leads to the damage of the nerves.
- Inflammation of the nerves as a result of autoimmune responses where your immune system mistakenly attacks your body cell thinking they are foreign organisms.
- Some genetic factors can also be responsible for nerve damages – even factors that are not related to diabetes.
- Alcohol abuse and smoking can also cause damage to the nerves and the blood vessels
- Some other risk factors could also include kidney disease, prolonged time having diabetes, being overweight or obese, and smoking.
What are the Symptoms of Diabetic Neuropathy?
The signs and symptoms of diabetic neuropathy can vary, depending on the type of neuropathy it is and also on the types of nerves affected. There are mainly 4 types of neuropathy that occur in people living with diabetes:
#1: Peripheral Neuropathy
This the most common type and often affects the feet and legs first before moving to the hands and arms. It can cause numbness or pain in the legs, toes, feet, arms, hands, increased sensitivity to touch, loss of reflexes (especially in the ankles), muscle weakness, and loss of balance and coordination.
#2: Autonomic Neuropathy
This impairs the functioning of the digestive system, leading to some conditions like diarrhea or constipation. It can also cause impairment in bladder function. Autonomic neuropathy can also affect the way you perspire as well as affect your sexual responses. While men may have difficulty getting an erection, it could cause vaginal dryness in women. It can also lead to lack of awareness of low blood sugar level (hypoglycemia awareness).
#3: Focal Neuropathy
Focal neuropathy is common in older adults and often comes on suddenly. It affects nerves in the face, torso, or legs causing symptoms like paralysis on one side of the face, double vision, pain in the shin, lower back pain, and pain in the chest or abdomen.
#4: Proximal Neuropathy
This condition is more common among older adults and people living with type 2 diabetes. It often affects nerves in the buttocks, hips, thighs, and legs. It may cause sudden severe pain in the buttocks or hips, difficulty rising up from a sitting position, weight loss, abdominal swelling, or weakness in thigh muscles.
How Can I Prevent Diabetic Neuropathy?
There are lots of things you can do to prevent nerve damage and a host of things you can do if you are suffering from neuropathy.
- The simplest way to prevent diabetic neuropathy is to keep your blood sugar level in a healthy balance.
- Plan your meals so your blood sugar levels remain at healthy levels throughout the day.
- Get an A1C test at least twice a year to track your blood glucose levels for the past few months.
- Report symptoms of diabetic neuropathy to your diabetes care team
- Early treatment will help complications down the road.
- Take good care of your feet, inspect them regularly and note any changes.
- Talk to your care team about special shoes if required.
- Taking acetaminophen, aspirin or ibuprofen can help reduce moderate pain. Talk to your doctor before starting any medications even if they are over-the-counter.
- Ask your doctor if you should add a B Vitamin complex. Vitamin B12 is important to your nerve health.
- Some research has suggested Vitamin D can prevent pain from neuropathy.
- Talk to your healthcare provider about taking Alpha-Lipoic Acid, a supplement which may relieve pain.
- Use relaxation techniques such as massage, yoga, and meditation.
Steven Chessler, M.D., Ph.D., is an Associate Professor and physician-scientist in the Department of Medicine, Division of Endocrinology, at the UC Irvine School of Medicine. He treats patients with diabetes and a variety of other endocrine disorders and, in the laboratory, carries out diabetes- and pancreatic-islet-related research.
1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), February 2017. ” Diabetes, Heart Disease, and Stroke.” Accessed March 30, 2018. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke
2. McVitamins.com. “Autoimmune Reaction & Neuropathy.” Accessed March 30, 2018. http://www.mcvitamins.com/causes%20of%20neuropathy/autoimmune-reaction-neuropathy.htm
3. J Peripher Nerv Syst. 2005 Dec;10(4):354-8. “Obesity and peripheral neuropathy risk: a dangerous liaison.” Accessed April 1, 2018. https://www.ncbi.nlm.nih.gov/pubmed/16279984