Diabetic neuropathy is a type of nerve damage associated with diabetes. It results in damage to the nerves in a person’s feet, legs, eyes, and those controlling bodily functions, such as digestion, blood pressure and heart rate. Diabetic neuropathy can lead to serious complications, including ulcers]]> , infection, and loss of limb.
Nerves of the Foot
Researchers believe that diabetic neuropathy is likely caused by a combination of factors, including:
The following factors are thought to increase the risk of diabetic neuropathy:
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
- Nausea or vomiting
- Diarrhea]]> or ]]>constipation]]>
- Dizziness or faintness
- 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]]> .
Your doctor will ask about your symptoms and medical history, and perform 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 (QSART)—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
Talk with your doctor about the best treatment plan for you. Treatment options include:
Blood Glucose Management
It is important to regularly monitor blood glucose levels. You can bring them within normal range with meal planning, exercise, and/or medications.
If you have diabetic neuropathy, you will need to take special care of your feet, since the nerves in the feet are the ones most often affected by neuropathy. This care will involve regular visits to a foot doctor and careful cleaning, inspection, moisturizing, and grooming of your feet. In addition, always wearing well-fitting shoes or slippers and thick, soft, seamless socks can help protect your feet from injuries.
Other treatments will depend on your symptoms. Medications can be used to relieve pain, burning, tingling, or numbness. Oftentimes, the medications used to treat these symptoms are the same types of medications used to treat seizures]]> and ]]>depression]]> .
Modifying your diet and/or taking ]]>erythromycin]]> or another antibiotic can help with gastrointestinal problems. Taking care when sitting or standing, increasing salt intake, or taking medications can help manage dizziness and weakness. An antibiotic can be prescribed to treat a ]]>urinary tract infection]]> . Medications can be used to treat erectile dysfunction, and vaginal lubricants are recommended to treat vaginal dryness.
If you are diagnosed with diabetic neuropathy, follow your doctor's instructions .
American Diabetes Association
National Diabetes Information Clearinghouse
Canadian Diabetes Association
American Academy of Neurology practice parameters for diagnostic testing for distal symmetric polyneuropathy. Neurology. December 3, 2008.
Diabetic neuropathies. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000693.htm .
Diabetic neuropathies: the nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/ . Accessed May 24, 2007.
Diabetic neuropathy. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed February 2, 2009.
Harati Y, Bosch EP. Disorders of peripheral nerves. In: Bradley WG, et al, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, PA: Butterworth Heinemann Elsevier; 2008.
Ogawa K, Sasaki H, Yamasaki H, et al. Peripheral nerve functions may deteriorate parallel to the progression of microangiopathy in diabetic patients. Nutr Metab Cardiovasc Dis. 2006;16:313-321.
Stewart JD. Diabetic neuropathies. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. Medline website. Available at: http://www.medlink.com . Accessed August 10, 2007.
Vinik AI. Diabetic neuropathies. Med Clin North Am. 2004;88:947-999.
Last reviewed January 2009 by ]]>J. Thomas Megerian, MD, PhD, FAAP]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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