University of Maryland Center for Diabetes and Endocrinology

Complications of Diabetes

Diabetic Neuropathy (Nerve Problems)

What is Diabetic Neuropathy?

Diabetic neuropathy, a nerve disorder, is a complication of diabetes that can lead to problems throughout the body.

Persons with diabetes can develop nerve problems at any time, but significant clinical neuropathy can develop within the first 10 years after receiving a diabetes diagnosis. The risk of developing neuropathy increases the longer a person has diabetes. About 60 percent of people with diabetes have some form of neuropathy.

What Causes Diabetic Neuropathy?

Although the exact causes of diabetic neuropathy are unknown, several factors may contribute to the disorder, including the following:

high blood glucose
High blood glucose causes chemical changes in nerves and impairs the nerves' ability to transmit signals. It also has the potential to damage blood vessels that carry oxygen and nutrients to the nerves.
inherited factors
There are some genetic traits that may make some people more susceptible to nerve disease than others.

What are the Symptoms of Diabetic Neuropathy?

The following are the most common symptoms of diabetic neuropathy. However, each individual may experience symptoms differently. Symptoms include:

numbness in the hands or feet
pain in the hands, feet, or legs
problems with internal organs such as the digestive tract, heart, or sexual organs causing the following:
- indigestion
- diarrhea or constipation
- dizziness
- bladder infections
- impotence
- weakness
- weight loss
- depression

The symptoms of diabetic neuropathy may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

What are the Different Types of Diabetic Neuropathy?

Diffuse neuropathy is neuropathy that affects many parts of the body, and includes the following:

diffuse peripheral neuropathy - neuropathy that affects nerves in the extremities (legs, feet, arms, and hands).

Symptoms include:
- numbness
- tingling, burning, or prickling
- sharp pains or cramps
- extreme sensitivity to touch
- loss of balance or coordination
- insensitivity to pain or temperature changes
diffuse autonomic neuropathy - neuropathy that affects nerves that serve internal organs, processes, and systems of the heart, digestive system, sexual organs, urinary tract, and sweat glands.

Symptoms include:
- incontinence
- digestive problems
- low blood pressure
- dizziness
- fainting
- impaired perception of pain
- hypoglycemia
- profuse sweating
focal neuropathy - neuropathy that affects a single, specific nerve and part of the body, such as the eyes, facial muscles, hearing, pelvis and lower back, thighs, and abdomen.

Symptoms include:
- pain in the thighs
- severe pain in lower back or pelvis pain in the chest, stomach, or flank chest or abdominal pain that mimics angina, heart attack, or appendicitis
- aching behind the eyes
- inability to focus the eyes
- double vision
- paralysis on one side of face
- hearing problems

How is Neuropathy Diagnosed?

In addition to a complete medical history and physical examination, the physician may:

check muscle strength
check muscle reflexes
check muscle sensitivity to the following:
- position
- vibration
- temperature
- light touch

The phsyician may also request additional tests, such as:

nerve conduction studies (to check flow of electrical current through a nerve)
electromyography (to determine how muscles respond to electrical impulses)
ultrasound (to determine how parts of the urinary tract are functioning)
nerve biopsy (to remove a sample of nerve for examination)

Treatment for Neuropathy:

Specific treatment for neuropathy will be determined by your physician based on:

your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

The goal of treatment is to relieve pain and discomfort, as well as to prevent additional tissue damage. Treatment may include:

pain medications
antidepressant medications
topical creams
transcutaneous electronic nerve stimulation (TENS) therapy
hypnosis
relaxation training
biofeedback training
acupuncture

Treatment may also be prescribed for complications of neuropathy, such as gastrointestinal problems, dizziness and weakness, and urinary or sexual problems.

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This page was last updated on: July 20, 2012.

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