Nerve damage - diabetic
Diabetic neuropathy is damage to nerves in the body that occurs due to high blood sugar levels from diabetes.
Nerve injuries are caused by decreased blood flow and high blood sugar levels. They are more likely to develop if blood sugar 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 20 years after diabetes has been diagnosed.
Nerve injuries may affect:
Symptoms often develop slowly over several years. They can vary depending on the nerves that are affected.
People with diabetes may have trouble digesting food. These problems can make your diabetes harder to control. Symptoms of this problem are:
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:
Damage to nervves in your heart and blood vessels may cause you to:
Other symptoms of nerve damage are:
A physical exam may show:
Tests that may be done include:
It is very important to keep your blood sugar in a healthy range. You should learn the basic steps for managing your diabetes, avoiding its complications, and staying as healthy as possible. These steps will include diet, exercise, and sometimes medicines.
You may need to check your blood sugar daily, or more often. Your doctor will help you by taking blood tests and other tests.
The following medications may be used to reduce symptoms in the feet, legs, and arms:
Treatments for nausea and vomiting may include:
Diarrhea, constipation, bladder problems, and other symptoms are treated as needed.
Drugs such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) may be used for treating impotence. Discuss these medicines with your doctor before taking them.
To keep your feet healthy, you should:
See also: Diabetes foot care
Treatment relieves pain and can control some symptoms, but the disease generally continues to get worse.
Neuropathy may also hide angina, the warning chest pain for heart disease and heart attack.
Call your health care provider if you develop symptoms of diabetic neuropathy.
Tight control of blood sugar levels may prevent neuropathy in many people with type 1 diabetes, and may reduce the severity of symptoms.
In addition, regular foot care can prevent a small infection from getting worse. This is why no appointment for diabetes care is complete without a thorough foot examination.
Eisenbarth GS, Polonsky KS, Buse JB. Type 1 diabetes mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 31.
Wong MC, Chung JW, Wong TK. Effects of treatments for symptoms of painful diabetic neuropathy: systematic review. BMJ. 2007;335:87.
American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011 Jan;34 Suppl 1:S11-61.
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