The most common form of diabetic nerve damage is a loss of feeling in your feet. Less often, it damages the nerves in your hands, or the nerves that control heart rate, digestion, and your bladder.
What is the cause?
The exact reason that diabetes damages nerves is not known. When you have diabetes, you may have poor blood flow, which can damage nerves. High blood sugar can also damage nerves. You can help prevent or delay nerve damage with good control of your blood sugar. Other things that can increase your risk for nerve damage include:
Smoking, which causes poor blood flow
Long-term, heavy alcohol use
Not enough vitamin B-12 or folic acid in your diet
What are the symptoms?
Symptoms often start slowly over many years. You can have nerve damage and not notice any symptoms. If you do have symptoms, they may include:
Numbness, â€œpins and needlesâ€, or a loss of feeling (usually first in the feet or hands)
Pain ranging from minor discomfort or tingling in fingers and toes to severe pain, which may be sharp, burning, or a deep ache that makes it hard to sleep or do daily activities
Painful sensitivity to the slightest touch
Lightheadedness when you get up too quickly from sitting or lying down
Fast or irregular heartbeats
Trouble emptying your bladder
Constipation or diarrhea
Nausea or vomiting
Sexual problems, such as trouble getting an erection in men and vaginal dryness or orgasm problems in women
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:
MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the muscles and nerves
Nerve conduction studies, which use small wires that are taped to your skin to send mild electric signals and check how well your nerves work to carry signals to your muscles
Your healthcare provider may refer you to a specialist for some tests.
How is it treated?
There is no cure for neuropathy. The best approach is to prevent it by keeping your blood sugar under control.
Muscle weakness is treated with support, such as splints. Physical therapy can also help with exercises for the weak muscles. Exercises can be used to strengthen all muscle groups to keep you as fit as possible.
To help relieve the pain, your provider may recommend or prescribe cream, skin patches, or medicines you take by mouth. Medicines can be used to treat nausea, vomiting, and diarrhea.
Some people get relief through acupuncture or biofeedback. Acupuncture uses special needles to stimulate the release of your body’s natural painkillers. Biofeedback therapy trains you to be aware of your body and how it works. You are connected to a machine that senses your body’s response and gives you feedback in the form of lights or sounds. During the treatment sessions you will be asked to relax and pay attention to how you feel and how your feelings change the feedback. You can learn to control some of your feelings with biofeedback.
If you have nerve damage that causes a loss of feeling, injuries are serious problems because you cannot feel if something is hot, painful or sharp. Diabetes also makes it harder for injuries to heal. You need to be extra careful to avoid burns, cuts, and other injuries.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. In addition:
Check your feet every day. Look for injuries on the skin of your feet and lower legs.
See your healthcare provider promptly if you have redness, bumps, blisters, or sores on your skin so they can be properly treated right away.
See your provider or a foot specialist about corns or calluses on your feet.
Ask your provider about how to trim your toenails properly.
Wear good-fitting, comfortable shoes that protect your feet.
If you have nerve damage or a foot problem, itâ€™s best to avoid heavy lifting, jogging, treadmill or step exercises, and walking long distances. If you have lost feeling in your feet, activities like bicycling or swimming are safer. Talk with your healthcare provider about an exercise program that is right for you.
If you are a man who has trouble having erections, (erectile dysfunction or ED), talk to your healthcare provider. Your provider may prescribe medicine or mechanical devices to help. Ask your provider if your problem is related to the diabetes and what might be done about it.
Ask your provider:
How and when you will hear your test results
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
How can I help prevent diabetic nerve damage?
The best way to help prevent diabetic nerve damage is to:
Control your diabetes. Try to keep your blood sugar in the range recommended by your healthcare provider.
Keep your blood pressure under good control and cholesterol (blood fats) at healthy levels.
Exercise regularly according to your healthcare provider’s recommendation.
If you smoke, try to quit. Smoking worsens the effects of diabetes, creates blockages in the blood vessels, and increases your risk of complications. Talk to your healthcare provider about ways to quit smoking.
Limit the amount of alcohol you drink because alcohol can cause nerve damage too.
Eat a healthy diet with plenty of fruits and vegetables every day.
Look at your feet at the end of each day to check for reddened areas, cuts, or scrapes that could get infected. A mirror can help you see all surfaces of your feet, or you can ask someone for help. You can also use your hands to feel for hot areas, bumps, or sore spots.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2015-01-05 Last reviewed: 2015-01-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
National Diabetes Information Center. Diabetic Neuropathies: the Nerve Damage of Diabetes. US Dept of Health and Human Services, National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases. 6/25/2012. NIH Publication No. 08-3185.February 2009. Accessed 3/27/2013 from http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/#cause.