What is diabetic neuropathy?

Diabetic neuropathy is a complication of diabetes that affects the nerves.

The most common type of diabetic neuropathy affects the peripheral nerves. It is called peripheral neuropathy. The peripheral nerves are the nerves that go out from the brain and spinal cord to the muscles, skin, internal organs, and glands. Peripheral neuropathy causes these sensory and motor nerves to not work properly.

Diabetic neuropathy can also affect the nerves that regulate unconscious vital functions, such as heart rate and digestion. These nerves make up the autonomic nervous system, and this type of problem is called autonomic neuropathy.

How does it occur?

Doctors do not understand how diabetes damages the nervous system.

What are the symptoms?

The symptoms of peripheral neuropathy include:

• numbness and loss of feeling (usually first in the feet or hands)

• slower reflexes

• pain varying from minor discomfort or tingling sensations in fingers and toes to severe pain; pain may be sharp or lightninglike, deep aches that make sleep or daily activities difficult, or sensitive skin that responds to the slightest touch

• weak muscles.

The symptoms of autonomic neuropathy include:

• low blood pressure and dizziness when you rise quickly from sitting or lying down

• rapid or irregular heartbeats

• trouble having an erection

• nausea or vomiting

• difficulty swallowing

• constipation and diarrhea.

How is it treated?

There is no specific treatment for neuropathy. The best approach is to control the diabetes.

Muscle weakness is treated with support, such as splints. Pain-killing drugs or cream applied to the skin might help pain during the night. Medications can be used to treat nausea, vomiting, and diarrhea.

How can I take care of myself?

Neuropathy worsens other diabetes-related complications. 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. Inspect the skin on your feet and lower legs regularly. See your health care provider promptly for calluses, sores on the skin, or other potential problems so they can be treated properly.

Men who have trouble having erections should talk to their health care providers. There are medications and devices that can be put in the penis to help a man achieve and maintain an erection.

How long will the effects last?

Because neuropathy is a complication of diabetes, the risk of neuropathy will continue as long as you have diabetes. If your diabetes is kept under control, however, the risk may be greatly reduced.

How can I help prevent diabetic neuropathy?

The best way to help prevent diabetic neuropathy is to control your diabetes. Try to keep your level of blood sugar at a normal level. Maintaining normal blood pressure also helps. In addition, you can:

• Stop smoking.

• Limit the amount of alcohol you drink.

• Have regular physical exams.

• Have regular blood and urine tests.

• Exercise regularly, according to your health care provider's recommendation.