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Diabetic Neuropathy

Pain Conditions We Treat

When you have diabetes, your blood sugar level may get too high. Over time, high blood sugar levels can damage nerves. This is called diabetic neuropathy.

Nerve damage can cause pain, burning, tingling, and numbness and may leave you feeling weak. The feet are often affected. When you have nerve damage in your feet, you cannot feel your feet and toes as well as normal and may not notice cuts or sores. Even a small injury can lead to a serious infection. It is very important that you follow your doctor's advice on foot care.

Sometimes diabetes damages nerves that help the body function. If this happens, your blood pressure, sweating, digestion, and urination might be affected. Your doctor may give you a target range for your blood sugar that is higher or lower than you are used to. Try to keep your blood sugar very close to this target range to prevent more damage.

What are the symptoms of diabetic neuropathy?

Your symptoms depend on which nerves are injured. Early symptoms are often pain, burning, and tingling in your feet. This can lead to numbness and serious infections because sores or other problems may not get treated.

Other symptoms may include:

  • Problems with digestion, like bloating, belching, constipation, nausea and vomiting, diarrhea, and belly pain.
  • Problems with body temperature, like heavy sweating at night or when you eat certain foods. You may have reduced sweating, especially in your feet and legs.
  • Problems with urination, such as having trouble knowing when your bladder is full or finding it hard to empty your bladder completely.
  • Sexual problems, such as erection problems in men and vaginal dryness in women.
  • Heart and blood vessel problems that can lead to poor circulation or low blood pressure. This may cause dizziness, weakness, or fainting when you stand or sit up from a reclining position.
  • Trouble sensing when your blood sugar is low.
How can you prevent diabetic neuropathy?

Keeping your blood sugar levels in your target range recommended by your doctor may help prevent diabetic neuropathy. The best way to do this is by checking your blood sugar and adjusting your treatment. It's also important to get to and stay at a healthy weight by exercising and eating healthy foods.

What causes diabetic neuropathy?

Over time, high blood sugar levels from diabetes can damage nerves throughout your body. The higher your blood sugar levels, the more likely you are to have nerve damage.

Also, the older you get and the longer you have diabetes, the more likely you are to have nerve damage. People with diabetes who drink too much alcohol are also more likely to have nerve damage.

How is diabetic neuropathy diagnosed?

During a physical exam, your doctor may check how well you can feel light touch, temperature, pain, vibration, and movement. Your doctor may also check your strength and reflexes. Tests such as an electromyogram and nerve conduction studies may be done to confirm the diagnosis. You may need other tests to see which type of neuropathy you have and to help guide your treatment.

Doctors can't test for all types of nerve damage. So it's important to tell your doctor about any pain or weakness you feel. Also mention heavy sweating or dizziness and any changes in digestion, urination, and sexual function.

How is diabetic neuropathy treated?

Treatment for diabetic neuropathy involves keeping blood sugar levels in your target range. This will not cure nerve damage. But it can help keep the damage from getting worse. And it may help relieve pain.

It helps to have healthy habits, such as seeing your doctor regularly, controlling your blood pressure, eating a balanced diet, exercising regularly, not smoking, and limiting or avoiding alcohol.

Other treatments depend on your symptoms. They may include:

  • Medicines to treat pain, digestive problems, or blood vessel problems.
  • Medicines or the use of compression stockings to treat blood pressure problems.
  • Treatments for sexual problems. Medicines or devices may help improve erections. Or lubricating creams may help vaginal dryness.
  • A splint or brace to help treat a nerve problem.

When you have diabetes, you could have a sore or other foot problem without noticing it. So check your feet every day. An untreated problem on your foot can lead to a serious infection or even amputation.

Work together with your doctor to find the treatment that helps you the most.

Treatment if the condition gets worse

If diabetic neuropathy gets worse, you may have serious problems such as severe gastroparesis, bladder infections, or foot problems. Along with keeping your blood sugars in your target range and taking good care of your feet, you may need more treatment.

Diabetic neuropathy is a major risk factor for foot infections or foot ulcers. This may lead to amputation. It is possible to have permanent damage in one or both of your feet (such as Charcot foot) from diabetic neuropathy. Surgery is sometimes needed to repair deformed joints that can result from Charcot foot.

Severe bladder infections or other bladder problems may require more testing and treatment.

Also, it is common to have symptoms of depression with any long-term (chronic) disease. Getting help for depression may improve your overall well-being and help you treat your condition.