Diabetic Peripheral Neuropathy
Home Causes of Peripheral Neuropathy Diabetic Peripheral Neuropathy
Diabetic neuropathy, or nerve damage caused by diabetes, is one of the most common known causes of neuropathy. It is one of many complications associated with diabetes, with nearly 60 percent of diabetics having some form of nerve damage. It is a progressive disease that can involve loss of sensation, as well as pain and weakness, in the feet and sometimes in the hands. Peripheral neuropathy may be more prevalent in people who have difficulty managing their blood sugar levels, have high blood pressure, are overweight, and are over 40 years old. A clinical examination may identify early signs of neuropathy in diabetics without symptoms.
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Today, doctors are exploring a link between pre-diabetes (also known as impaired glucose tolerance or IGT) and peripheral neuropathy. Approximately 10% of adults in America have what is being called “pre-diabetes” or “borderline diabetes”—a condition where the body has higher than normal blood sugar levels, but not high enough to be diagnosed as true diabetes. If left untreated, people with pre-diabetes are at risk of developing type 2 diabetes, heart disease, and nerve damage (which could result in peripheral neuropathy.)
People with pre-diabetes or IGT can significantly reduce their risk of developing type 2 diabetes through diet, exercise and learning to control their blood sugar levels.
Pre-Diabetes Symptoms & Signs
(Not all symptoms and signs may be present.)
People with IGT often have no symptoms. People who actually have diabetes—and who therefore are at greater risk of developing peripheral neuropathy—often don’t realize it because the symptoms of diabetes come on so gradually. Pre Diabetic symptoms and its complications include:
- Frequent urination
- Blurred vision
- Constant thirst
- Fatigue
- Frequent infections
- Cuts and bruises that heal slowly
- Tingling or numbness in the hands or feet
Pre-Diabetic Neuropathy Symptoms
In feet or hands:
- Pain
- Numbness
- Tingling Sensations
Pre-Diabetes Tests
(Not all evaluation and tests may be necessary.)
To test for pre-diabetes:
- Blood test
- Oral glucose tolerance test
Diabetic Neuropathy Tests
- Physical examination
- Neurological exam
- Electromyography
- Nerve conduction velocity test
Pre-Diabetes Treatments
(Not all treatments and therapies may be indicated.)
- Over-the-counter pain medication for mild pain
- Take safety measures to compensate for loss of sensation.
- Ask your doctor about special therapeutic shoes (which may be covered by Medicare and other insurance).
Pre-Diabetic Neuropathy Treatments
- Lose weight
- Eat a balanced diet
- Exercise
- Stop smoking
The first sign of diabetic neuropathy is usually numbness, tingling or pain in the feet, legs or hands. Over a period of several years, the neuropathy may lead to muscle weakness in the feet and a loss of reflexes, especially around the ankle. As the nerve damage increases, the loss of sensation in the feet can reduce a person’s ability to detect temperature or to notice pain. Because the person can no longer notice when his/her feet become injured, people with diabetic neuropathy are more likely to develop foot problems such as skin lesions and ulcers that may become infected.
Diabetic neuropathy may suddenly flare up and affect a specific nerve or group of nerves. When this occurs, the result may be weakness and muscle atrophy in various parts of the body, such as involvement of the eye muscles or eyelid (e.g., causing double vision or a drooping eyelid) or thigh muscles. Alternatively, neuropathy caused by diabetes may slowly progress over time. It also can interfere with the normal functioning of the digestive system and sexual organs.
Diabetic Neuropathy Symptoms
(Not all symptoms and signs may be present.)
- Numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
- Indigestion, nausea, or vomiting
- Diarrhea or constipation
- Dizziness or faintness due to a drop in blood pressure especially when rising to a standing position
- Problems with urination
- Erectile dysfunction (impotence) or vaginal dryness
Diabetic Neuropathy Tests
(Not all evaluation and tests may be necessary.)
- Comprehensive foot exam
- Physical examination
- Neurological exam
- Electromyography
- Nerve conduction velocity test
- Quantitative sensory testing (QST)
- Nerve or skin biopsy
- Blood studies to verify diabetes (e.g., HbA1C) and to rule out other potential causes
Is there any treatment?
The goal of treatment for diabetic neuropathy is to relieve discomfort and to prevent further tissue damage. The first step is to bring blood sugar levels under control by diet and medication. Another important part of treatment involves taking special care of the feet.
Diabetic Neuropathy Treatment
(Not all treatments and therapies may be indicated.)
- Over-the-counter pain medication for mild pain
- For severe pain, take over-the-counter pain medication or prescription drugs used for peripheral neuropathy, on a regular basis—rather than waiting until nighttime when symptoms can become more severe
- Keep blood sugar levels in normal range
- Get regular exercise
- Maintain a healthy weight
- Antidepressants (for pain relief)
- Foot care: inspect your feet daily for injuries
- Special therapeutic shoes (which may be covered by Medicare and other insurance)
- Take safety measures to compensate for loss of sensation
Please Read our Blog Posts about Diabetic Neuropathy:
Chinese Herbal Medicine Lessened Progression to Type 2 Diabetes
Diabetes is the most common cause of peripheral neuropathy. Researchers at the University of Chicago, found that the use of Chinese herbal medicine for 12
Tibial Nerve Decompression Failed to Improve Painful Diabetic Polyneuropathy
It has been hypothesized that the development of diabetic polyneuropathy (DPN) is due to swelling of the nerve, as well as thickening and stiffening of
ADA's 2014 Standards of Care Emphasizes Individualized Treatment
The ADA’s annually revised Standards of Medical Care in Diabetes was just released with an emphasis on individualized treatment of diabetes. Their position paper indicates
Blueberries, Apples, Grapes May Reduce Diabetes Risk
A new study suggests that eating more fruit, particularly blueberries, apples and grapes, may reduce the risk of diabetes. The researchers found that for every
Pharmacologic Management of Diabetic Peripheral Neuropathic Pain
A comprehensive and systematic review of published literature for the treatment of diabetic peripheral neuropathy (DPN) from 1965 through 2012 has been completed at the
New and Developing Drugs for the Treatment of Neuropathic Pain in Diabetes
Dr. Roy Freeman, Beth Israel Deaconess Medical Center, received funding from the NIH to pursue the review of specific drugs, newly approved or in development,
Sudoscan Test Efficiently Detected Diabetic Neuropathy
Dr. Aaron Vinik, MD, PhD, Professor of Medicine and Director of Research at Eastern Virginia Medical School, and his team have developed an FDA-approved device which
Duloxetine and Pregabalin: High-dose monotherapy or their combination?
Duloxetine (ie, Cymbalta, and others) and pregabalin (ie, Lyrica) are used in the first line of treatment for diabetic peripheral neuropathy but have been shown to
Painful and Painless Diabetic Peripheral Neuropathy: One Disease or Two?
Researchers in Endocrinology at the university of Tor Vergata, Rome, published a review of available literature dealing with the similarities and differences between painful and
Phase 1/2 Open-label Dose-escalation Study of Plasmid DNA Expressing Two Isoforms of Hepatocyte Growth Factor in Patients with Painful Diabetic Peripheral Neuropathy
A team of researchers from the Department of Neurology, Northwestern University, reported on Phase 1/2 results of a study to evaluate the safety and preliminary
Efficacy and Safety of Carisbamate in Patients with Diabetic Peripheral Neuropathy or Postherpetic Neuralgia
Findings from 3 proof-of-concept studies have been published evaluating the efficacy and safety of carisbamate, a novel neurotherapeutic agent, in the treatment of neuropathic pain.
Behavioral Therapy Eases Pain from Diabetic Neuropathy
A controlled clinical study from Boston University School of Medicine and the Veterans Administration indicates that cognitive behavioral therapy (CBT) can help relieve chronic pain
FPN's Resource Library
The Foundation for Peripheral Neuropathy is the leader in providing resources to patients, caregivers, and physicians.
FPN’s Resource Library contains educational brochures, newsletters, transcripts and videos that cover many topics from treatments to research updates to the numerous causes of peripheral neuropathy.
We hope that you find our Resource Library to be of help to you and your loved ones.