Diabetic Neuropathy

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CAUSES AND SYMPTOMS

OF DIABETIC NEUROPATHY

Diabetic neuropathies are a family of nerve disorders caused

by diabetes. People with diabetes can, over time, have damage

to nerves throughout the body. Neuropathies lead to numbness

and sometimes pain and weakness in the hands, arms, feet, and

legs. Problems may also occur in every organ system, including

the digestive tract, heart, and sex organs. People with diabetes

can develop nerve problems at any time, but the longer a person

has diabetes, the greater the risk.

An estimated 50 percent of those with diabetes have some form

of neuropathy, but not all with neuropathy have symptoms. The

highest rates of neuropathy are among people who have had the

disease for at least 25 years.

Diabetic neuropathy also appears to be more common in people

who have had problems controlling their blood glucose levels,

in those with high levels of blood fat and blood pressure, in

overweight people, and in people over the age of 40. The most

common type is peripheral neuropathy, also called distal

symmetric neuropathy, which affects the arms and legs.

Causes The causes are probably different for different varieties

of diabetic neuropathy. Researchers are studying the effect of

glucose on nerves to find out exactly how prolonged exposure to

high glucose causes neuropathy. Nerve damage is likely due to a

combination of factors:

- metabolic factors, such as high blood glucose, long duration

of diabetes, possibly low levels of insulin, and abnormal

blood fat levels

- neurovascular factors, leading to damage to the blood vessels

that carry oxygen and nutrients to the nerves

- autoimmune factors that cause inflammation in nerves

- mechanical injury to nerves, such as carpal tunnel syndrome

- inherited traits that increase susceptibility to nerve disease

- lifestyle factors such as smoking or alcohol use

Symptoms depend on the type of neuropathy and which nerves are

affected. Some people have no symptoms at all. For others,

numbness, tingling, or pain in the feet is often the first

sign. A person can experience both pain and numbness. Often,

symptoms are minor at first, and since most nerve damage occurs

over several years, mild cases may go unnoticed for a long time.

Symptoms may involve the sensory or motor nervous system, as

well as the involuntary (autonomic) nervous system. In some

people, mainly those with focal neuropathy, the onset of pain

may be sudden and severe.

Symptoms may include:

- numbness, tingling, or pain in the toes, feet, legs, hands,

arms, and fingers

- wasting of the muscles of the feet or hands

- indigestion, nausea, or vomiting

- diarrhea or constipation

- dizziness or faintness due to drop in postural blood pressure

- problems with urination

- erectile dysfunction (impotence) or vaginal dryness

- weakness

In addition, the following symptoms are not due to neuropathy

but nevertheless often accompany it:

- weight loss

- depression

Source: NIDDK

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