Diabetes: Nerve Damage

What nerve damage is caused by diabetes?

The most common form of diabetic nerve damage is loss of feeling in the hands and feet. The medical term for nerve damage caused by diabetes is diabetic neuropathy. When it affects the hands and feet it is called peripheral neuropathy.

The nerves that control body functions, such as heart rate and digestion, can also be affected. This type of problem is called autonomic neuropathy.

How does it occur?

Doctors have been studying diabetic nerve damage for many years, but they do not yet understand how diabetes damages the nervous system. However, they do know that you can help prevent it with good control of blood sugar levels.

What are the symptoms?

You can have peripheral neuropathy and not notice any symptoms. If you do have symptoms, they may include:

• numbness or a tingling feeling of “pins and needles”
• loss of feeling (usually first in the feet or hands)
• slower reflexes
• pain ranging from minor discomfort or tingling in fingers and toes to severe pain
• sharp or lightninglike pain
• a burning pain
• a deep ache that makes sleep or daily activities difficult
• painful sensitivity to the slightest touch
• weak muscles.

The symptoms of autonomic neuropathy include:

• lightheadedness when you get up quickly from sitting or lying down
• fast or irregular heartbeats
• trouble emptying the bladder
• constipation or diarrhea
• abdominal pain
• nausea or vomiting
• trouble swallowing
• trouble having an erection.

How is it treated?

There is no cure for neuropathy. The best approach is to prevent it by controlling your blood sugar.

Muscle weakness is treated with support, such as splints. Physical therapy can also help with exercises for the weak muscles. Exercises can be used to strengthen all muscle groups to keep you as fit as possible.

Pain-killing drugs or cream put on the skin may help pain during the night. Medicines can be used to treat nausea, vomiting, and diarrhea.

If you have nerve damage in your feet or hands, injuries are a serious problem because you can't feel if something is hot or sharp. Diabetes also makes it harder for injuries to heal. It is very important to be extra careful to avoid burns, cuts, and other injuries.

How long will the effects last?

The nerve damage will not go away. However, you may be able to prevent more damage by keeping your blood sugar under good control.

How can I take care of myself?

Nerve damage makes other diabetes-related complications worse. For example, if you have lost feeling in your feet and legs, you may not know you have an injury or infection until it develops into a bad sore. Make sure you:

• Look for injuries on the skin of your feet and lower legs daily.
• See your provider promptly if you have redness, bumps, blisters, or sores on your skin so they can be treated properly.
• See your healthcare provider or a podiatrist about corns or calluses on your feet.
• Ask your provider about how to trim your toenails properly.
• Wear good-fitting, comfortable shoes that protect your feet.

Men who have trouble having erections, which is a condition called erectile dysfunction (ED) or impotence, should talk to their healthcare providers. There are medicines to help a man get and maintain an erection. There are also mechanical devices to help. Ask your provider if your problem is related to the diabetes and what might be done about it. Urologists are the medical specialists who usually help with ED.

How can I help prevent diabetic nerve damage?

The best way to help prevent diabetic nerve damage is to:

• Control your diabetes. Try to keep your blood sugar at a normal level.
• Do not smoke. Smoking damages blood vessels and decreases blood flow, especially to your feet. The decreased blood flow makes skin infections more likely.
• Keep your blood pressure at a normal level.
• Keep your cholesterol (blood fats) at a healthy level.
• Exercise regularly according to your healthcare provider's recommendation to keep good blood flow, especially in the feet and legs.
• Limit the amount of alcohol you drink because alcohol can cause nerve damage too.
• Eat a healthy diet with fruits and vegetables (some vitamin deficiencies can cause neuropathy).
• Keep your checkup appointments with your healthcare provider.

For more information contact:

• American Diabetes Association, Inc.
  Phone: 800-DIABETES, or 800-342-2383
  Web site: http://www.diabetes.org