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Diabetic neuropathy: MedlinePlus Medical Encyclopedia (Print Version) URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/000693.htm Diabetic neuropathy is damage to nerves in the body that occurs due to high blood sugar levels from .
Nerve injuries are caused by decreased blood flow and high They are more likely to develop if bloodsugar levels are not well controlled.
About half of people with diabetes will develop nerve damage. Most of the time symptoms do not begin until 10 to 20years after diabetes has been diagnosed.
Nerves in the skull (cranial nerves)Nerves from the spinal column and their branchesNerves that help your body manage vital organs, such as the heart, bladder, stomach, and intestines (calledautonomic neuropathy) Symptoms often develop slowly over several years. Which symptoms you have depend on the nerves that are affected.
People with diabetes may have trouble digesting food. This can make your diabetes harder to control. Symptoms ofdigestion problems include: Feeling full after eating only a small amount of foodand bloatingNausea, constipation, or diarrheaSwallowing problemsThrowing up food a few hours after a meal Tingling or burning in the arms and legs may be an early sign of nerve damage.
These feelings often start in your toes and feet.
You may have deep pain, often in the feet and legs.
Nerve damage may cause you to lose feeling in your arms and legs. Because of this you may: Not notice when you step on something sharpNot know that you have a blister or small cutNot notice when you touch something that is too hot or cold Damage to nerves in your heart and blood vessels may cause you to: Feel light-headed when you stand up (orthostatic )Have a fast heart rate www.nlm.nih.gov/medlineplus/ency/article/000693.htm Diabetic neuropathy: MedlinePlus Medical Encyclopedia (Print Version) Not notice angina, the chest pain that warns of heart disease and heart attack Sexual problems. Men may have problems with erections. Women may have trouble with vaginal dryness ororgasm.
Not being able to tell when your blood sugar gets too lowBladder problems. You may leak urine and may not be able to tell when your bladder is full. Some people are notable to empty their bladder.
Sweating too much -- when the temperature is cool, when you are at rest, or at other unusual times A lack of reflexes in the ankleA loss of feeling in the feet (your health care provider will check this with a brush-like instrument called amonofilament)Changes in the skinDrop in blood pressure when you stand up after sitting or lying down (EMG) -- a recording of electrical activity in musclesNerve conduction velocity tests (NCV) -- a recording of the speed at which signals travel along nerves It is very important to Doing so may prevent nerve damage or make symptomsless severe.
You should learn the basic steps for managing your diabetes, avoiding its complications, and staying as healthy aspossible. These steps will include diet, exercise, and sometimes medicines.
You need to check your blood sugar regularly. Your doctor will help you by taking blood tests and other tests.
A number of medications may be used to reduce painful symptoms in the feet, legs, and arms: Pregabalin (Lyrica) (often the first treatment used)Certain drugs that are also used to treat depression, such as amitriptyline (Elavil), doxepin (Sinequan), orduloxetine (Cymbalta)Certain drugs that are also used to treat seizures, such as gabapentin (Neurontin), carbamazepine (Tegretol),and valproate (Depakote)Narcotic pain medicines Treatments for nausea and vomiting may include: Taking medicines that help food move more quickly through your stomach and intestinesSleeping with your head raisedEating smaller, more frequent meals Diarrhea, constipation, bladder problems, and other symptoms are treated as needed.
Drugs such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) may be used to treat impotence. Discuss www.nlm.nih.gov/medlineplus/ency/article/000693.htm Diabetic neuropathy: MedlinePlus Medical Encyclopedia (Print Version) these medicines with your doctor before taking them.
Check and care for your feet EVERY DAYGet a foot exam by your doctor at least once every year, and have your health care provider check your feet atevery quarterly visit.
Make sure you wear the right kind of shoes.
Treatment relieves pain and can control some symptoms, but the disease generally continues to get worse.
Bladder or kidney infectionNeuropathy that may hide the symptoms of angina, chest pain that warns of heart disease and a heart attack Call your health care provider if you develop any symptoms of diabetic neuropathy.
Nerve damage - diabetic; Diabetes - neuropathy Bril V, England J, Franklin GM, Backonja M, Cohen J, Del Toro D, et al. Evidence-based guideline: Treatment of painfuldiabetic neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular andElectrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology.
American Diabetes Association. Standards of medical care in diabetes--2012. Diabetes Care. 2012 Jan;35 Suppl 1:S11-63.
Updated by: Shehzad Topiwala, MD, Chief Consultant Endocrinologist, Premier Medical Associates, The Villages, FL.
Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.
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