Diabetic Nerve Damage: An Overview

Sixty to 70 percent of people with diabetes suffer some form of nerve damage or diabetic neuropathy, according to the National Diabetes Information Clearinghouse (NDIC). While the brain and spinal cord aren't usually affected, neuropathies can develop in many other parts of the body, such as the extremities (feet and hands), internal organs and genitalia. Because nerves are so critical to a variety of functions in your body—from sensation to breathing and digestion—any damage to them can have serious health implications.

There are four types of diabetic neuropathy:

  • Peripheral neuropathy (also called distal symmetric polyneuropathy or sensorimotor neuropathy) is the most common and affects your feet, hands, toes, and fingers.
  • Autonomic neuropathy occurs in the internal organs and can lead to complications such as indigestion, eye problems, high blood pressure, heart problems and loss of sexual function.
  • Focal neuropathy causes sudden weakness in one nerve or a group of nerves that leads to muscle weakness or pain.
  • Proximal neuropathy causes pain and weakness in your buttocks, hips and thighs.

Symptoms of Diabetic Neuropathy

Nerve damage caused by diabetes can occur over a long period of time. In some cases, you may not notice any symptoms, especially depending on which part of the body is affected. Also, symptoms may be intermittent, occurring for a short period of time and then disappearing. These are common signs of nerve damage from diabetes:

  • Numbness, pain, or tingling in your hands, feet, arms or legs
  • Trouble digesting your food
  • Poor bladder or bowel control
  • Nausea or vomiting
  • Loss of muscle mass in your feet or hands
  • Dizziness, faintness, or weakness
  • Vaginal dryness or erectile dysfunction
  • Vision problems

Causes of Diabetic Neuropathy

One of the main causes of diabetic nerve damage is high blood glucose, which may directly impair the nerves, or may reduce blood supply and oxygen that the nerves need. Other factors include low insulin levels, abnormal blood fat levels, and inflammation of the nerves. In some cases, another co-existing illness may be the cause of nerve damage, not diabetes.

How to Prevent Diabetic Neuropathy

The risk of diabetic nerve damage is higher the longer you have diabetes, or if your blood glucose levels have been high for a long period. Here's how to put the odds in your favor:

1. Control your blood glucose levels. This is the most important way to prevent diabetic nerve damage. Be sure to monitor it regularly, take your medication, such as insulin injections, on schedule. Also, watch your diet and exercise regularly. According to the ADA, you can cut your risk of diabetic neuropathy by up to 60 percent if you manage your diabetes intensively.

2. Get an A1C test (a lab test). This should be done at least twice a year to determine your average blood glucose for the past two to three months.

3. Get regular medical check ups. Because you may not notice some symptoms, it's important not to skip these exams. Testing may include checking your reflexes and your sensitivity to touch.

4. Do a daily body check. Inspect your feet daily for blisters, cuts, redness, sores, swelling, or tender nails.

Treatment for Diabetic Neuropathy

Getting your blood glucose level as close to normal as possible is the first way to treat diabetic neuropathy. This will reduce your symptoms and avoid further nerve damage and other complications of diabetes. Also, practice good foot hygiene and choose proper footwear to lower your risk of developing Charcot foot, or foot ulcers.

Diabetic neuropathy can also be painful. Your doctor may recommend medications commonly used to relieve diabetic nerve pain. These include antidepressants such as Paxil® or Wellbutrin®, or opioids such as oxycodone and tramadol. Over-the-counter meds such as acetaminophen and ibuprofen are not very useful for nerve pain.

Some alternative remedies for diabetic nerve pain include acupuncture, biofeedback, physical therapy (which also combats muscle weakness), magnetic therapy and electrical nerve stimulation.

For sexual problems caused by diabetic neuropathy, your doctor may recommend treatments such as vaginal lubricants to relieve dryness, or medications for erectile dysfunction.