What is Diabetic Neuropathy?

Diabetes can harm your nerves. That damage, called neuropathy, may be painful.

It can happen in several ways, and they all seem to be related to blood sugar levels being too high for too long. To prevent it, work with your doctor to manage your blood sugar.

You may hear your doctor mention the four types of diabetes-related neuropathy: peripheral, autonomic, proximal, and focal.

Peripheral Neuropathy

This type usually affects the feet and legs. Rare cases affect the arms, abdomen, and back.

Symptoms include:

• Tingling
• Numbness (which may become permanent)
• Burning (especially in the evening)
Pain

Early symptoms usually get better when your blood sugar is under control. There are medications to help manage the discomfort.

What you should do:

• Check your feet and legs daily.
• Use lotion on your feet if they're dry.
• Take care of your toenails. Ask your doctor if you should go to a podiatrist.
• Wear shoes that fit well. Wear them all the time, so your feet don't get injured.

Autonomic Neuropathy

This type usually affects the digestive system, especially the stomach. It can also affect the blood vessels, urinary system, and sex organs.

In your digestive system:

Symptoms include:

• Bloating
• Diarrhea
• Constipation
• Heartburn
• Nausea
• Vomiting
• Feeling full after small meals

What you should do: You may need to eat smaller meals and take medication to treat it.

In blood vessels:

Symptoms include:

• Blacking out when you stand up quickly
• Faster heartbeat
• Dizziness
• Low blood pressure
• Nausea
• Vomiting
• Feeling full sooner than normal

If you have it: Avoid standing up too quickly. You may also need to wear special stockings (ask your doctor about them) and take medicine.

In Men:

Symptoms include: They may not be able to have or keep an erection, or they may have “dry” or reduced ejaculations.

What you should do: See your doctor, because there are other possible causes than diabetes. Treatment includes:

• Counseling
• Penile implant or injections
• Vacuum erection device
• Medication

In Women:

Symptoms include: Can include less vaginal lubrication and fewer or no orgasms.

What you should do: See your doctor. Treatments include:

• Vaginal estrogen creams, suppositories, and rings
• Medications to help sex not feel painful
• Lubricants

In the Urinary System:

Symptoms include:

• Trouble emptying your bladder
• Bloating
• Incontinence (leaking urine)
• More bathroom trips at night

What you should do: Tell your doctor. Treatments may include:

• Medication
• Inserting a catheter into the bladder to release urine (self- catheterization)
• Surgery

Proximal Neuropathy

This type causes pain (usually on one side) in the thighs, hips, or buttocks. It can also lead to weakness in the legs.

Most people with this condition need treatment, such as medication and physical therapy, for their weakness or pain.

Focal Neuropathy

This type can appear suddenly and affect specific nerves, most often in the head, torso, or leg. It causes muscle weakness or pain.

Symptoms include:

• Double vision
• Eye pain
• Paralysis on one side of the face (Bell's palsy)
• Severe pain in a certain area, such as the lower back or leg(s)
• Chest or belly pain that is sometimes mistaken for another condition, such as heart attack or appendicitis

What you should do: Tell your doctor about your symptoms. Focal neuropathy is painful and unpredictable. But it tends to improve by itself over weeks or months. It usually doesn’t cause long-term damage.

Other Diabetes Nerve Damage

People with diabetes can also get other nerve-related conditions, such as nerve compressions (entrapment syndromes).

Carpal tunnel syndrome is a very common type of entrapment syndrome. It causes numbness and tingling of in the hand and sometimes muscle weakness or pain.

If you think you may have any type of nerve problem, talk with your doctor, so they can check for the cause.

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