Diabetic neuropathy is nerve damage due to diabetes. Over time, high blood sugar (glucose) can damage the tiny blood vessels that supply your nerves, especially in the legs.
Nerves send messages to and from your brain about pain, temperature, and touch. They tell your muscles when and how to move. They also control the systems in the body that digest food and pass urine.
If you have diabetes, you can develop nerve problems at any time. Serious nerve problems can develop within the first 10 years after being diagnosed with diabetes. The risk of getting neuropathy grows the longer you have diabetes. About half of people with diabetes have some form of nerve damage.
The exact cause of diabetic neuropathy is unknown. Several things may contribute to it, including:
These are the most common symptoms of diabetic neuropathy:
The symptoms of diabetic neuropathy may look like other conditions or medical problems. See your healthcare provider for a diagnosis.
To diagnose neuropathy, you will need a physical exam and other special tests. For example, ultrasound is used to check urinary issues. Ultrasound uses sound waves to visualize your bladder. Stomach issues can be identified with X-rays and other diagnostic tests. An electrocardiogram (EKG) can detect changes in your heart's rhythm due to neuropathy.
In addition, your healthcare provider may:
Check how your nerves respond to:
Request more tests, such as:
Your healthcare provider will figure out the best treatment for you based on:
The goal of treatment is to ease pain and discomfort. It’s also important to prevent more tissue damage. Treatment may include:
Treatment may also be prescribed for complications of neuropathy. This could be GI (gastrointestinal) problems, dizziness and weakness, and urinary or sexual problems.
One complication of neuropathy can happen when the bladder becomes paralyzed. When this happens, the nerves of the bladder no longer respond normally as the bladder fills with urine. As a result, urine remains in the bladder, leading to urinary tract infections.
Neuropathy may cause erectile dysfunction (ED) when it affects the nerves that control erection. However, the desire for sex does not usually fall.
Diarrhea may happen when the nerves that control the small intestine are damaged. The diarrhea happens mostly at night. Constipation is another result of damage to nerves in the intestines.
Sometimes, the stomach is also affected. It may lose the ability to move food easily through the digestive system. This causes vomiting and bloating and is called gastroparesis. It changes how fast the body absorbs food. It can make it more difficult to match insulin doses to food portions.
Dizziness and fainting can happen when the nerves to the heart no longer assist in maintaining adequate blood pressure with changes in posture.
Vision can also be affected by retinopathy. This begins with changes in blood vessels of the retina. This affects the light-sensitive tissues at the back of the eye. In some cases, the blood vessels can swell or leak fluid. In other cases, there is abnormal growth of new blood vessels on the surface of the retina. Over time, this can lead to vision loss and blindness.
Your eye healthcare provider may treat retinopathy by using a laser to make tiny burns. These burns seal the blood vessels and stop them from growing and leaking.
You may lose the protective warnings signals of low blood sugar, such as nervousness and shakiness.
Tips to help you get the most from a visit to your healthcare provider:
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