What is diabetic neuropathy?

Diabetic neuropathy is a type of nerve damage that occurs when you have diabetes. High blood sugar can damage the nerves in the body, especially the nerves in the legs.

Depending on the nerves damaged, the symptoms of diabetic neuropathy can range from pain and numbness in the legs to problems with the digestive system, urinary tract, blood vessels and heart, according to the Myoclinic. Some people have mild symptoms, but for some, diabetic neuropathy can be quite painful and debilitating.

Diabetic neuropathy is a serious complication of diabetes that can affect up to 50% of people with diabetes, but you can often prevent or slow the progression of diabetic neuropathy by managing your blood sugar consistently and following a healthy lifestyle. Give.

Symptoms of diabetic neuropathy

There are four main types of diabetic neuropathy in which a person can experience one or more types of neuropathy. The symptoms will depend on your nerves and the symptoms usually develop gradually. The person may not notice the disease until significant nerve damage has occurred.

Peripheral neuropathy

This type of neuropathy may also be called distal symmetrical peripheral neuropathy. This is the most common type of diabetic neuropathy, affecting the legs first and then the hands and arms. Signs and symptoms of peripheral neuropathy often get worse at night and may include numbness or decreased ability to feel pain or temperature changes, tingling or burning sensation, severe pain or cramping, increased sensitivity to touch for some people, and even bedspread weight. It can also be painful and cause serious problems in the foot such as wounds, infections and bone and joint pain.

Autonomic neuropathy

The autonomic nervous system controls your heart, bladder, stomach, intestines, genitals and eyes. Diabetes can affect the nerves in any of these areas and may cause a lack of awareness of low blood sugar levels (lack of awareness of hypoglycemia), bladder or intestinal problems, slow gastric emptying (gastroparesis), nausea, There is vomiting and loss of appetite, changes in the way your eyes adjust from light to dark and reduced sexual response.

Proximal neuropathy

This type of neuropathy, also called diabetic amyotrophy, often affects the nerves in the thighs, buttocks or legs. It can also affect the abdomen and chest. Symptoms usually occur on one side of the body, but may spread to the other side. You may experience severe pain in the thighs or buttocks, weakness and contraction of the thigh muscles, difficulty getting up from a sitting position, and severe stomach pain in this position.


Mononuropathy is divided into two types, cranial and peripheral, and refers to damage to a specific nerve. Mononuropathy can also lead to difficulty concentrating or seeing, eye pain, paralysis on one side of the face, numbness or tingling in the hands or fingers, and weakness in the hands.

When to see a doctor

Be sure to see your doctor if you have any of the following:

An incision or wound on your foot that is infected and does not heal

Burning, tingling, weakness or pain in the hands or feet that interferes with daily activities or sleep

Changes in digestion, urine or sexual function

Dizziness and fainting

The American Diabetes Association recommends screening for diabetic neuropathy immediately after diagnosis of type 2 diabetes and five years after diagnosis of type 1 diabetes, followed by annual screening.

Read more: Diabetic foot pain; Cause, symptoms, diagnosis and treatment of diabetic foot pain

Read more: Why do people with diabetic feet need regular checkups?

Causes of diabetic neuropathy

The exact cause of each type of neuropathy is still unknown, and researchers believe that over time, uncontrolled blood sugar damages nerves and impairs their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of small blood vessels (capillaries) that supply oxygen and nutrients to the nerves.

risk factors Diabetic neuropathy

Anyone with diabetes can develop neuropathy, but these factors increase your risk of nerve damage:

Poor blood sugar control: Uncontrolled blood sugar puts you at risk for any complication of diabetes, including nerve damage.

History of diabetes: The risk of developing diabetic neuropathy The more you develop diabetes, especially if your blood sugar is not well controlled.

Kidney disease: Diabetes can damage the kidneys and can lead to nerve damage by sending toxins into the blood.

Being overweight: Having a high body mass index may increase your risk of developing diabetic neuropathy.

Smoking: Smoking narrows the arteries and reduces blood flow to your legs, damaging the peripheral nerves.

Complications Diabetic neuropathy

Diabetic neuropathy can cause a number of serious complications, including:

Lack of awareness of hypoglycemiaBlood sugar levels below 70 mg / dL typically cause tremors, sweating, and rapid heartbeat, but if you have autonomic neuropathy, you may not notice these warning signs.

Toe or foot injury: Nerve damage can make your legs feel numb, so even minor cuts can turn into sores without you realizing it. In severe cases, the infection can even spread to the bone or cause tissue death. It may be necessary to remove (amputate) the toe, foot or even the leg.

Infection and urinary incontinence: If the nerves that control your bladder are damaged, you may not be able to empty your bladder completely. Bacteria can accumulate in the bladder and kidneys and cause urinary tract infections. Nerve damage can also affect your ability to feel when you need to urinate or control your urinary release muscles, leading to leakage (incontinence).

Severe drop in blood pressure: Damage to the nerves that control blood flow can affect the body’s ability to regulate blood pressure, which can cause a severe drop in blood pressure when standing after sitting, which can lead to dizziness and fainting.

Digestive problems: If nerve damage affects your digestive system, you may experience constipation or diarrhea, or both. Diabetic nerve damage can lead to gastroparesis, a condition in which the stomach empties very slowly or does not empty at all, causing bloating and indigestion.

Sexual dysfunction: Autonomic neuropathy often damages the nerves that affect the sexual organs, and men may experience erectile dysfunction. Women may also have difficulty lubricating and stimulating.

Increase or decrease sweating: Nerve damage can disrupt the way your sweat glands work.

Prevention of diabetic neuropathy

With careful blood sugar control and careful foot care, you can prevent or delay diabetic neuropathy and its complications.

Blood sugar management

The American Diabetes Association recommends that people with diabetes have an A1C test at least twice a year. This test estimates your average blood sugar level over the past two to three months.

Foot care

Leg problems such as wounds that do not heal and even amputation are common complications of diabetic neuropathy, but you can ask your doctor to check your feet once a year, and take good care of your feet at home. Strategies can somewhat reduce the consequences of this disease.

To protect the health of your feet, do the following:

Examine your feet every day: Look for blisters, cuts, bruises, cracks and peeling of the skin, redness and swelling. Use a mirror or ask a friend or family member to help you examine parts of the foot that are difficult to see.

Keep your feet clean and dry: Wash your feet daily with lukewarm water and mild soap. Avoid getting your feet wet, and carefully dry your feet, even between your toes.

Moisten your feet: This will help prevent cracking, but do not apply lotion between your toes as it may cause the fungus to grow.

Carefully trim your toenails: Carefully trim your toenails. The edges of your nails should not be sharp.

Wear clean and dry socks: Look for socks made of cotton fibers or dehumidifiers that do not have tight straps or thick seams.

Wear pillow shoes that fit perfectly: Always wear shoes or slippers to protect your feet. Make sure your shoes are the size of your feet and that your toes move easily. A foot doctor can teach you how to avoid problems such as corns and calluses by choosing the right shoes.

Translator: Elahe Zarei

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