Diabetic Neuropathy

What Is Diabetic Neuropathy?

Diabetic neuropathy, a common complication of diabetes, is damage to the nerves that allow you to feel sensations such as pain. There are a number of ways that diabetes damages the nerves, but they all seem related to blood sugar being too high for a long period of time.

Diabetes-related nerve damage can be painful, but it isn't severe pain in most cases.

There are four types of diabetic neuropathy: peripheral, autonomic, proximal, and focal.

Diabetic Peripheral Neuropathy

The areas of the body most commonly affected by diabetic peripheral neuropathy are the feet and legs. Nerve damage in the feet can result in a loss of foot sensation, increasing your risk of foot problems. Injuries and sores on the feet may go unrecognized due to lack of sensation. Therefore, you should practice proper skin and foot care. Rarely, other areas of the body such as the arms, abdomen, and back may be affected.

Symptoms of diabetic peripheral neuropathy may include:

• Tingling
• Numbness (severe or long-term numbness can become permanent)
• Burning (especially in the evening)  
• Pain

In most cases, early symptoms of diabetic peripheral neuropathy will become less when blood sugar is under control. Medications can be taken to help control the discomfort if needed.

To prevent peripheral neuropathy:

• Work with your doctor to keep your blood sugar under tight control

To help prevent the complications of peripheral neuropathy:

• Examine your feet and legs daily.
• Apply lotion if your feet are dry.
• Care for your nails regularly (Go to a podiatrist, if necessary).
• Wear properly fitting footwear and wear them all the time to prevent foot injury.

Diabetic Autonomic Neuropathy

Diabetic autonomic neuropathy most often affects the digestive system, especially the stomach, blood vessels, urinary system, and sex organs. To prevent autonomic neuropathy, continuously keep your blood sugar levels well controlled.

Symptoms of diabetic autonomic neuropathy of the digestive system may include:

• Bloating
• Diarrhea
• Constipation
• Heartburn
• Nausea
• Vomiting
• Feeling full after small meals

Treatments of autonomic neuropathy of the digestive system may include:

• Eating smaller meals
• Medication

Symptoms of diabetic autonomic neuropathy of the blood vessels may include:

• Blacking out when you stand up quickly
• Increased heart rate
• Dizziness
• Low blood pressure
• Nausea
• Vomiting
• Early fullness

Treatments of autonomic neuropathy of the blood vessels may include:

• Avoid standing up too quickly
• Medications
• Wearing special stockings

Symptoms of autonomic neuropathy of the male sex organs may include:

• Unable to have or maintain an erection (erectile dysfunction)*
• "Dry" or reduced ejaculations

Note: Impotence needs to be evaluated by your doctor. It may be caused by your medicines or factors other than diabetes.

Treatments of autonomic neuropathy of the male sex organs include:

• Counseling
• Penile implant
• Vacuum erection device
• Penile injections
• Medication

Symptoms of autonomic neuropathy of the female sex organs may include:

• Decrease in vaginal lubrication
• Decrease in number of orgasms or lack of orgasm

Treatments of autonomic neuropathy of the female sex organs include:

• Counseling
• Vaginal estrogen creams, suppositories, and rings
• Lubricants

Symptoms of autonomic neuropathy of the urinary system may include:

• Unable to completely empty bladder
• Bloating
• Incontinence (leaking urine)
• Increased urination at night

Treatments of autonomic neuropathy of the urinary system include:

• Medication
• Self-catheterization (inserting a catheter into the bladder to release urine)
• Surgery