Diabetes-Related Nerve Problems

Neuropathy, a common complication of diabetes, is damage to the nerves that allow you to feel sensations such as pain. There are a number of ways that diabetes damages the nerves, and they are all linked to blood glucose (sugar) being too high for a long period of time.

Diabetes-related nerve damage can be painful, but it isn't severe in most cases. There are two major types of diabetic neuropathy: peripheral and autonomic.

Peripheral Neuropathy

The areas of the body most commonly affected by peripheral neuropathy are the feet and legs. Nerve damage in the feet can result in a loss of foot sensation, increasing your risk of foot problems like ulcers. Therefore, proper skin and foot care should be practiced. Rarely, the arms, abdomen, and back may be affected.

Symptoms of peripheral neuropathy may include:

• Tingling
• Numbness (severe or long-term numbness can become permanent)
• Burning
Pain

In many cases, symptoms will improve when blood glucose is controlled.

To help prevent peripheral neuropathy:

• Check your feet and legs daily -- look for blisters, calluses, and cuts.
• Apply lotion if your feet are dry, but avoid getting lotion in between your toes; this area should be kept dry.
• Care for your nails regularly (go to a podiatrist if necessary).
• Wear properly fitting footwear. Some people with bony abnormalities may require custom shoes to redistribute pressure.
• People with claudication may require a referral to a doctor or surgeon who specializes in poor circulation.
• Control blood sugar, cholesterol and high blood pressure.
• If you smoke, quit.

Autonomic Neuropathy

Autonomic neuropathy most often affects the digestive system, especially the stomach, blood vessels, urinary system, and sex organs. To prevent autonomic neuropathy, you need to continuously keep your blood glucose levels well controlled.

Symptoms of neuropathy of the digestive system may include:

• Bloating
• Diarrhea
• Constipation
• Heartburn
• Nausea
• Vomiting
• Feeling full after small meals
• Frequent episodes of labile blood sugar control

Treatments may include:

• Eating smaller meals
• Medicines

Symptoms of neuropathy of the blood vessels may include:

• Blacking out when you stand up quickly
• Increased heart rate
• Dizziness
• Low blood pressure

Treatments may include:

• Avoiding standing up quickly
• Salt supplementation
• Medicines
• Wearing special stockings

Symptoms of neuropathy of the male sex organs may include:

• Unable to have or maintain an erection (erectile dysfunction)*
• "Dry" or reduced ejaculations

Treatments may include:

• Counseling
• Penile implant
• External erection maintenance device
• Penile injections
• Medicine

*Impotence needs to be evaluated by your doctor. It may be caused by your medicines or factors other than diabetes.

Symptoms of neuropathy of the female sex organs may include:

• Decrease in vaginal lubrication
• Decrease in number of orgasms or lack of orgasm

Treatments may include:

• Counseling
• Estrogen
• Vaginal creams
• Lubricants

Symptoms of neuropathy of the urinary system may include:

• Unable to completely empty bladder
• Increased urinary tract infections
• Bloating
• Incontinence (leaking urine)
• Increased urination at night

Treatments may include:

• Medicines
• Self-catheterization (inserting a catheter into the bladder to release urine)
• Surgery

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