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:
Diabetic Peripheral Neuropathy Risk Highlighted in Children
Joanne Moser, MSN, CRNO, and a team of researchers have published a report asking for new guidelines for detection of diabetic peripheral neuropathy in children.
Cost of Diabetes Care in US Keeps Climbing
The total cost of diabetes in the US jumped from $174 billion in 2007, to $245 billion in 2012. Costs in 2012 included $176 billion in
Burden of Illness Associated with Painful Diabetic Peripheral Neuropathy Among Adults Seeking Treatment in the US
Pfizer, Inc. supported a study to characterize the burden of illness among adult patients with DPN receiving treatment in the US. They recruited 112 patients
Poor Footwear Adherence Led to High Risk for Reulceration in Diabetes
Only 22-36% of diabetic peripheral neuropathy patients self-report that they wear prescription footwear regularly, especially at home, according to researchers in the Netherlands. According to
Gait Abnormalities Found in Diabetic Neuropathy
Dr. Alessandra Martinelli and her colleagues from the School of Science and Technology in Brazil, evaluated the spatial variables of gait and isometric muscle strength
Weight-bearing versus Non-weight-bearing Exercise for People with Diabetes and Peripheral Neuropathy
Results of a randomized controlled clinical trial are being published to report on the effects of weight-bearing versus non-weight-bearing exercise for people with diabetic peripheral
Drug Offers New Pain Management Therapy for Diabetics
A new drug therapy, nabilone, has been tested at University of Calgary’s Hotchkiss Brain Institute. At the end of the study, patients reported less pain and
Recognizing and Treating Diabetic Peripheral Neuropathy
Dr. Charles E. Argoff, Albany (NY) Medical Center, discussed diabetic peripheral neuropathy at PAINWeek 2012. He provided instruction in how to recognize and treat DPN.
Drugs Similar in Efficacy for Neuropathic Pain in Diabetes
Julia Boyle, PhD., University of Surrey (UK), and colleagues conducted a study of Type 1 and Type 2 diabetics with chronic painful DPN taking common
FDA Approves NUCYNTA ER Extended Release Oral Tablets
Janssen Pharmaceuticals, Inc. announced the FDA has approved the supplemental New Drug Application for NUCYNTA ER extended-release tables for the management of neuropathic pain associated
Diabetic Nerve Pain More Common Than Doctors Think
The American Chronic Pain Society joined with Pfizer to conduct a survey on the prevalence of symptoms of diabetic peripheral neuropathy in patients with diabetes.
New Type of Stem Cell Preparation Could Bring Pain Relief to Diabetics
New study has been published showing the potential of stem cells providing relief to people suffering from painful diabetic peripheral neuropathy (DPN). Stem Cells Translational
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