Diabetic neuropathy
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Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet.
Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your legs and feet to problems with your digestive system, urinary tract, blood vessels and heart. Some people have mild symptoms. But for others, diabetic neuropathy can be quite painful and disabling.
Diabetic neuropathy is a common and serious complication of diabetes. But you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.
There are four main types of diabetic neuropathy. You can have one or more than one type of neuropathy. Your symptoms will depend on the type you have and which nerves are affected. Usually, symptoms develop gradually. You may not notice anything wrong until considerable nerve damage has occurred.
Peripheral neuropathy is the most common type of diabetic neuropathy. It affects the feet and legs first, followed by the hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include:
The autonomic nervous system controls your heart, bladder, stomach, intestines, sex organs and eyes. Diabetes can affect nerves in any of these areas, possibly causing:
Radiculoplexus neuropathy affects nerves in the thighs, hips, buttocks or legs. It’s more common in people with type 2 diabetes and older adults. Other names for this type are diabetic amyotrophy, femoral neuropathy or proximal neuropathy.
Symptoms are usually on one side of the body, but sometimes may spread to the other side. You may have:
Most people improve at least partially over time, though symptoms may worsen before they get better.
Mononeuropathy, or focal neuropathy, is damage to a specific nerve in the face, middle of the body (torso) or leg. It’s most common in older adults. Mononeuropathy often strikes suddenly and can cause severe pain. However, it usually doesn’t cause any long-term problems.
Symptoms usually go away without treatment over a few weeks or months. Your specific signs and symptoms depend on which nerve is involved. You may have pain in the:
Mononeuropathy may also cause nerve problems in the eyes and face, leading to:
Sometimes mononeuropathy occurs when something is pressing on a nerve (nerve compression). Carpal tunnel syndrome is a common type of compression neuropathy in people with diabetes. It can cause numbness or tingling in your hand or fingers, except your pinkie (little finger). Your hand may feel weak, and you may drop things.
Call your doctor for an appointment if you have:
These signs and symptoms don’t always mean you have nerve damage. But they can be a sign of another condition that requires medical care. Early diagnosis and treatment of any health condition gives you the best chance for controlling your diabetes and preventing future problems.
The exact cause likely differs for each type of neuropathy. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients.
However, a combination of factors may lead to nerve damage, including:
Anyone who has diabetes can develop neuropathy, but these risk factors make you more likely to get nerve damage:
Diabetic neuropathy can cause a number of serious complications, including:
You can prevent or delay diabetic neuropathy and its complications by keeping tight control of your blood sugar and taking good care of your feet.
Use an at-home blood sugar monitor to check your blood sugar and make sure it consistently stays within target range. It’s important to do this on schedule. Shifts in blood sugar levels can accelerate nerve damage.
The American Diabetes Association recommends that people with diabetes have the A1C test at least twice a year. This blood test indicates your average blood sugar level for the past two to three months. If your blood sugar isn’t well-controlled or you change medications, you may need to get tested more often.
Follow your doctor’s recommendations for good foot care.
Foot problems, including sores that don’t heal, ulcers and even amputation, are a common complication of diabetic neuropathy. But you can prevent many of these problems by having a comprehensive foot exam at least once a year, having your doctor check your feet at each office visit and taking good care of your feet at home.
To protect the health of your feet:
Keep your feet clean and dry. Wash your feet every day with lukewarm water and mild soap. Avoid soaking your feet. Dry your feet and between your toes carefully by blotting or patting with a soft towel.
Moisturize your feet thoroughly to prevent cracking. Avoid getting lotion between your toes, however, as this can encourage fungal growth.
Wear cushioned shoes that fit well. Always wear shoes or slippers to protect your feet from injury. Make sure that your shoes fit properly and allow your toes to move. A podiatrist (foot doctor) can teach you how to buy properly fitted shoes and to prevent problems such as corns and calluses.
If problems do occur, your doctor can help treat them to prevent more-serious conditions. Even small sores can quickly turn into severe infections if left untreated.
If you qualify for Medicare, your plan may cover the cost of at least one pair of shoes each year. Talk to your doctor or diabetes educator for more information.
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Diabetic neuropathy
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