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Choose a TopicAll ConditionsADD/ADHDAllergiesAlzheimer'sArthritisAsthmaBack PainBreast CancerCancerDentalDepressionDiabetesEye HealthHeart DiseaseHepatitisHIV/AIDSHypertensionMen's ConditionsMental HealthMigraines/HeadachesMultiple SclerosisOsteoporosisParkinson'sSexual ConditionsSkin & BeautyStrokeWeight ControlWomen's Conditions Health Topics | Symptoms | Medical Tests | Medications | Wellness | Support Organizations Topic Overview Health Tools Symptoms Exams and Tests Treatment Overview Home Treatment Other Places To Get Help Related Information References Credits Diabetic Neuropathy Topic Overview What is diabetic neuropathy? Diabetic neuropathy results from damage to the nerves of the peripheral nervous system, which connect the spinal cord and brain to the rest of the body. Neuropathy is a common complication of long-term diabetes. There are three types of neuropathy that occur in people with diabetes. Peripheral neuropathy reduces your ability to sense pain, touch, temperature, and vibration in certain parts of the body and may sometimes affect movement and muscle strength. It most often affects the feet and lower legs and may contribute to serious foot problems, such as ulcers, infection, and bone and joint deformities. It is the most common form of diabetic neuropathy. Autonomic neuropathy is caused by damage to the nerves that control the involuntary (autonomic) functions of your body, such as heartbeat, blood pressure, sweating, digestion, urination, and some aspects of sexual function. It is also common in people with diabetes. Focal neuropathy is far less common than peripheral neuropathy and autonomic neuropathy and, unlike these forms, usually develops suddenly. Focal neuropathy, sometimes called mononeuropathy, affects a single nerve, most often in the wrist, thigh, or foot. It may also affect the nerves of the back and chest, as well as those that control the eye muscles. Nerve entrapment, sometimes called compression neuropathy, causes swollen or inflamed tissues surrounding a nerve to press on and “trap” it. (An example of this is compression of the nerve in the wrist, or carpal tunnel syndrome. Although nerve entrapment is not directly caused by diabetes, people with diabetes are especially prone to this condition.) What are the symptoms? The damage caused by diabetic neuropathy can upset the normal flow of nerve impulses through the legs, arms, and other parts of the body. This may limit your ability to feel pain, which is one way the body protects itself against injury. (The sensation of pain tells your brain to pull your hand off the hot stove, for instance, or to remove the rock from your shoe.) When the internal organs and body systems are affected by neuropathy, it can cause: Digestive system problems, such as frequent bloating, belching, constipation, nausea and vomiting, diarrhea, and abdominal pain. Temperature regulation problems, such as profuse sweating of the torso, face, or neck at night or while eating certain foods, such as spicy foods and cheese. Alternatively, some people may have reduced sweating, especially in their feet and legs. Urinary system problems, such as difficulty sensing when the bladder is full or difficulty emptying the bladder completely. Sexual problems, such as erection problems in men and vaginal dryness in women. Heart and blood vessel problems, leading to poor circulation or low blood pressure. This may cause dizziness, weakness, or fainting when you stand or sit up from a reclining position. Difficulty knowing when your blood sugar is low. What causes it? The exact cause of diabetic neuropathy is not known, but a person's blood sugar level seems to have a greater effect on neuropathy than any other factor. The higher your blood sugar level, the greater your risk for developing neuropathy. The risk of nerve damage also increases the longer you have diabetes. Smoking and excessive alcohol consumption may further increase the risk. Nerve problems in a person with diabetes may also be caused by other conditions, such as thyroid disease and Lyme disease. Who is at risk? Most people with diabetes develop some neuropathy over the years, but only about 13% to 15% have noticeable symptoms.1 People who take insulin injections, those whose blood sugar levels do not stay within a safe range, or those who smoke are at increased risk for developing neuropathy.1 How is it diagnosed? Diagnosis of diabetic neuropathy is based on your medical history—largely your symptoms—and physical exam. If these indicate peripheral neuropathy, an electromyography (EMG) and nerve conduction studies may be done. If autonomic neuropathy is suspected, additional tests may be done to diagnose the condition and determine the cause and appropriate treatment. Which tests are indicated will depend on the organ or system affected. Can it be prevented? Severe neuropathy can often be avoided. If you have not developed nerve damage, keeping your blood sugar levels within a safe range may help prevent neuropathy. If you already have nerve damage, detecting it early and then maintaining a safe blood sugar level may help prevent neuropathy from becoming more severe and may reduce your risk of complications. How is it treated? Treatment focuses on preventing its occurrence and slowing the progression of the disease by consistently keeping your blood sugar levels within a safe range. You can keep your blood sugar levels within a safe range by taking your insulin or oral diabetes medication as prescribed, checking your blood sugar level often, following your diet for diabetes, exercising, and seeing your health professional regularly. See the topic Type 1 Diabetes or Type 2 Diabetes: Living With the Disease for more information about how to do these things. If you have peripheral neuropathy, treatment depends on the symptoms. Treatment to relieve pain (such as medications, physical therapy, or acupuncture) may be used. Treatment for autonomic neuropathy depends on the organ or system that is affected and may include medications for digestive system problems, elastic stockings and medications for blood vessel problems, devices to improve erections, or lubricating creams for vaginal dryness. If focal neuropathy is present, treatment may include a splint or brace; if the nerve is being compressed, surgery may be necessary. Frequently Asked Questions Learning about diabetic neuropathy: What is diabetic neuropathy? How does diabetes cause nerve disease? What are the symptoms of peripheral neuropathy? How do diabetic foot problems develop? What are the symptoms of autonomic neuropathy? What are the symptoms of focal neuropathy? What increases your risk? Who is affected by the condition? Being diagnosed: How is it diagnosed? What tests are done? What is a foot exam for neuropathy? Getting treatment: How is diabetic neuropathy treated? How is autonomic neuropathy treated? How are stomach problems (gastroparesis) treated? How is peripheral neuropathy treated? How is focal neuropathy treated? Ongoing concerns: How can it be prevented? How can complications be prevented? How can diabetic foot problems be prevented? Living with diabetic neuropathy: What precautions need to be taken during exercise? What can be done to delay worsening of the condition? What can you do if you have autonomic neuropathy? How can you care for your feet? ^back to top next section > To Search the Help Last updated: November 26, 2002 Print-Friendly Version © 1995-2004, Healthwise, Incorporated, P.O. Box 1989, Boise, ID 83701. All Rights Reserved.This information is not intended to replace the advice of a doctor. Medscape for Physicians | Medscape for Healthcare Professionals Corporate | Contact Us Terms and Conditions | Privacy Policy and Agreement ©1996-2004 WebMD Inc. All rights reserved. Quote Link to comment Share on other sites More sharing options...
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