Some people notice no symptoms. Often, symptoms are slight at first, since most nerve damage occurs over a period of years, mild cases may go unnoticed for a long time. Numbness and tingling in feet are often the first sign.

In some people, the onset of pain may be sudden and severe. There may be diffuse pain, affecting many parts of the body, or a single nerve and affecting one part of the body. There may cause both pain and insensitivity to pain in the same person. These are all symptoms of diabetic neuropathy.

The most common type of neuropathy in diabetics is peripheral neuropathy, which damages the nerves of the arms and legs, and especially the feet. The nervous system extends throughout the body and is responsible for coordinating muscles, the senses, speech, memories, thought and emotion.

People with diabetes can develop nerve problems at any time. Neuropathy can develop within the first 10 years after diagnosis of diabetes and the risk of developing neuropathy increases the longer someone has diabetes.

Diabetic neuropathy appears to be more common in smokers, people over 40 years of age, and those who have had problems controlling their blood glucose levels.

The cause of diabetic neuropathy is not known

The exact cause is not known. but several factors are likely to play a part in diabetic neuropathy. The high blood glucose leads to a build-up of sorbitol in nerves. This build-up changes how nerves' transmit signals to and from the the brain. High blood glucose levels are also believed to damage the blood vessels that carry oxygen and nutrients to the nerves.

Common symptoms of this kind of neuropathy are:

Numbness or insensitivity to pain or temperature Tingling, burning, or prickling Sharp pains or cramps Extreme sensitivity to touch, even light touch Loss of balance and coordination.

The damage to nerves often results in loss of reflexes and muscle weakness. The foot often becomes wider and shorter, the gait changes, and foot ulcers appear as pressure is put on parts of the foot that are less protected.

Because of the loss of sensation, injuries may go unnoticed and often become infected. If ulcers or foot injuries are not treated in time, the infection may involve the bone and require amputation.

However, problems caused by minor injuries can usually be controlled if they are caught in time. Avoiding foot injury by wearing well-fitted shoes and examining the feet daily can help prevent amputations.

Approaches used to relieve the symptoms of diabetic neuropathy

The first step is to bring blood sugar under control by diet and oral drugs or insulin injections, if needed, and by careful monitoring of blood sugar levels.

Although symptoms can sometimes worsen at first as blood sugar is brought under control, maintaining lower blood sugar levels helps reverse the pain or loss of sensation that neuropathy can cause. Good control of blood sugar may also prevent or delay the onset of other problems.

Initial treatments to treat diabetic neuropathy include hypnosis, relaxation training, biofeedback, and acupuncture. Some people find that walking regularly or using elastic stockings helps relieve leg pain. Warm (not hot) baths, massage, or an analgesic ointment such as capsaisin may also help.

Diabetic Neuropathy

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. Click here to Learn More...

Applying brief pulses of electricity to nerve endings under the skin, a procedure called transcutaneous electrical nerve stimulation (TENS), yields excellent pain relief in some diabetic patients.

The stimulation works best when applied to the skin near where the pain is felt and where other sensibilities like touch or pressure have not been damaged. Both the frequency and voltage of the electrical stimulation are important in achieving the sense of tingling and warmth that provides relief.

In the search for effective ways to treat diabetic neuropathy, the pain-relieving benefits from drugs not normally prescribed for pain have been discovered.

Certain anti-depressants such as amitriptyline (sometimes used with fluphenazine) are believed to increase the production of serotonin. Cells using serotonin are an integral part of a pain-controlling pathway that inhibits pain-conducting neurons in the brain or spinal cord.

Pain specialists think that the antidepressant works because it increases the supply of a naturally produced neurotransmitter, serotonin. It is thought that serotonin controls pain in the brain as well as the level of the spinal cord.

The use of anti-epileptic drugs like, Tegretol, Dilantin, Neurontin, is based on the premise that the nervous system depends on a proper balance of incoming and outgoing nerve signals.

When nerve fibers are damaged, the normal flow of messages to the brain is disturbed and becomes hyperactive. The nervous system goes haywire firing constantly. Anti-epileptic drugs reduce the excessive firings in the nervous system, and in that way relieve the pain.

To get the best results often requires a trial of several medicines, because people are different, what works for one person might not work for another. More importantly, it might take up to 12-18 months of treatment before you notice a change in the pain.

Newer treatments

Spinal cord stimulator- a small implanted device sends out electrical signals changing the pain signals are interpreted by the brain.

Nerve growth factors-chemicals that stimulate the repair of damaged nerves.

Some General Hints

Many people who exercise regularly find the pain of neuropathy less severe, it helps improve circulation, and strengthens muscles. Smoking makes circulatory problems worse and increases the risk of neuropathy and heart disease. Reduce the amount of alcohol you drink, as few as four drinks per week can worsen neuropathy. Take special care of your feet.