• Diabetes

What is Diabetic Neuropathy?

Diabetes is a common condition affecting millions of people in the United States. One of the complications of diabetes is diabetic neuropathy — damage to the nerves of people with type 1 or type 2 diabetes. Nearly half of those with diabetes will experience some type of diabetic neuropathy.

There are four different types of diabetic neuropathy. Peripheral neuropathy is the most common type. It causes nerve damage that leads to pain in the feet, legs, and sometimes the hands and arms. 

If you have already been diagnosed with diabetes, your healthcare provider may perform a series of diagnostic tests for diabetic neuropathy.

Signs and Symptoms of Diabetic Neuropathy

Diabetic neuropathy can make it more difficult for your body to sense pain. For example, you may not immediately notice when you step on something sharp because of damaged nerves. 

In some cases, diabetic neuropathy can affect the nerves that control digestion. This can make it more difficult for the body to digest food and lead to digestive conditions like gastroparesis.

Depending on where the damaged nerves are, it can lead to symptoms like:

• Pain

• Numbness 

• Tingling

• Swollen feet

• Blisters and sores

• Nausea

• Sexual dysfunction

• Loss of balance

While rare, you may experience worsening symptoms at night. If severe, chronic pain can lead to anxiety and depression. Be sure to let a healthcare provider know if you need mental health support.

How is Diabetic Neuropathy Diagnosed?

A healthcare provider can perform a series of tests to diagnose diabetic neuropathy. A low blood pressure may indicate that you have diabetic neuropathy. During a routine visit, they will ask about your medical history and perform a routine physical exam. 

Your healthcare provider may request a neurological exam to check for abnormal brain activity.  They may also suggest additional tests to know which nerves have been affected including:

Foot exams: A healthcare provider will place a tuning fork against your foot to see if you are feeling any sensations there.

Monofilament tests: Placing the foot against a nylon strand to test for sensation in the foot.

Reflex tests: A healthcare provider may test reflexes in your ankles and test your balance

What Causes Diabetic Neuropathy?

Diabetic neuropathy is caused by high blood sugar and high cholesterol levels. Blood sugar imbalances reduce proper blood flow. High levels of fat — specifically triglycerides — can damage nerves and small blood vessels. In some cases, low vitamin B12 levels can lead to diabetic neuropathy.

What are the different types of diabetic neuropathy?

There are four main types of diabetic neuropathy depending on which nerve signals have been impacted.

Types of diabetic neuropathy a person may be diagnosed with include:

Peripheral neuropathy: Nerve damage in the feet and legs. As it progresses, it may also occur in the hands and arms.

Autonomic neuropathy: Nerve damage to the internal organs. It can cause complications with your heart rate, blood pressure, bladder, and eyes when internal organs are affected.

Focal neuropathy: Damage to single nerves in the head, hand, torso, and leg can lead to carpal tunnel syndrome. 

Proximal neuropathy: This type of diabetic neuropathy is rare. It causes nerve damage in the hip, buttock, or thigh that can demobilize one side of the body.

Treatment Options for Diabetic Neuropathy

Nerve damage cannot be reversed once it starts. While there is no cure for diabetic neuropathy, there are steps you can take to manage it.

If low vitamin B12 levels are an issue for you, a healthcare provider may recommend a vitamin B12 supplement or medications like Glucophage (metformin).

The main focus for a healthcare provider is to reduce pain for those with diabetic neuropathy. They may recommend the following for better pain management:

• Anticonvulsants (medications that treat seizures) such as gabapentin and pregabalin

• Skin creams, patches, or sprays like lidocaine

• Physical therapy for strength and balance

Many people with chronic pain may also experience feelings of anxiety and depression. In some cases, your healthcare provider may prescribe antidepressants. Be sure to speak with your healthcare provider about any additional side effects you experience.

How to Prevent Diabetic Neuropathy

Diabetic neuropathy is a side effect of diabetes that can be prevented through lifestyle changes to keep blood sugar and cholesterol levels low.

You can speak with your healthcare provider about using a continuous glucose monitor (CGM) to monitor your blood sugar levels at home. Following a well-balanced diet low in cholesterol and saturated fats helps with keeping your blood sugar in a healthy range. Getting into a consistent exercise routine can also help your blood sugar and overall health. Be sure to reach out to your healthcare provider about ways to modify exercises if you experience diabetic neuropathy in your feet. 

When you have diabetes, you may have to see your healthcare provider more than once or twice a year. Be sure to keep up with your appointments and have your healthcare provider continue to monitor your glucose levels.

When to See a Healthcare Provider

Diabetic neuropathy can interrupt daily life if it’s preventing wounds from healing in your body. If you notice this happening, see a healthcare provider right away. Be sure to contact your healthcare provider if you experience dizziness, fainting, or any other severe symptoms.

At LifeMD, you can speak with a licensed healthcare provider about ways to manage your blood sugar and keep your cholesterol low. They can also provide tips on how to maintain a well-balanced diet and keep a consistent exercise routine during treatment.

Book an appointment today to learn more about options to manage diabetic neuropathy.

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