Diabetic neuropathy is a disorder of the nerves caused by persistently high blood glucose levels.

A common long-term complication of diabetes, it is where the nerves in the body become damaged to the point where they no longer function.

People with both type 1 and type 2 diabetes, can develop neuropathy, particularly patients who have had diabetes for a long time and have not managed their condition well, or those with higher levels of blood fat and blood pressure.

Around 60% to 70% of people with diabetes are estimated to be affected by some form of nerve damage

What causes diabetic neuropathy?

A number of factors can cause diabetic neuropathy:

High blood glucose levels

Neuropathy can be directly caused by high blood sugar levels. High concentrations of glucose in the blood can damage the tiny blood vessels in the body (capillaries) which supply the nerves with oxygen and other nutrients.

Without sufficient nutrients the affected nerves can stop working, which can impair how the body responds to pain or heat or the functioning of muscles and other organs.

Other risk factors

There are other factors associated with the onset of neuropathy. These are:

  • High blood pressure
  • Obesity
  • Prolonged alcohol misuse
  • Vitamin B deficiency
  • Smoking
  • Liver and kidney disease
  • Charcot-Marie-Tooth-Disease

What are the symptoms of diabetic neuropathy?

Neuropathy can have a wide range of symptoms, due to the many things nerves affect in the body.

Usually, the first sign of neuropathy is a tingling or a burning sensation in the extremities – the hands, arms, legs, and especially in the feet. These feelings normally start mild and get progressively more pronounced as more nerves are damaged.

However, sometimes neuropathy causes sudden, sharp, spikes of pain.

Further symptoms may include:

  • Wasting of muscles in the hands and feet
  • Diarrhea
  • Constipation
  • Indigestion and nausea
  • Erectile dysfunction
  • Dizziness
  • Weakness

Types of neuropathy

There are a number of types of neuropathy, with each form categorized by which nerves are affected.

Sensory neuropathy

This form of neuropathy occurs when the nerves that deal with the senses, particularly the feeling of touch, become damaged. This can cause numbness, a reduced ability to feel pain, or reduce the ability to detect temperature changes. It can also cause a burning sensation within the skin and sharp stabbing pains.

Neuropathy can also affect the efficiency with which your body heals. This is why it is so important for people with diabetes to take care of their feet.

A foot wound or ulcer may go unnoticed because of sensory neuropathy, and either high blood glucose levels or poor circulation can impair healing of the the wound. These factors can greatly increase the risk of wound infection occurring. In extreme cases, wound infection may have to be dealt with by amputation.

People with diabetes should have their feet examined at least once a year by a medical professional, as well as checking them daily themselves.

Motor neuropathy

In cases where the nerves that control the muscles are affected, this is known as motor neuropathy.

By causing a reduced ability to move and coordinate parts of the body, motor neuropathy can lead to a variety of difficulties, including muscle weakness, loss of coordination, muscle twitching and paralysis of certain parts of the body.

Because of the way a lack of coordination can affect someone’s ability to walk, motor neuropathy can have large affects on the feet. By persistently walking off balance, deformities in the foot can form as pressure is applied unnaturally to the bones, and because of sensory neuropathy, the sufferer may not be able to tell.

Autonomic neuropathy

Autonomic neuropathy affects the nerves in the body that control involuntary actions, such as digestion or heart rate. If these nerves fail, certain automatic functions that your body carries out may be affected.

Autonomic neuropathy can have a wide array of symptoms and complications because of this. Some of the main complications it can cause include:

  • Diarrhea and constipation
  • Nausea
  • Excessive sweating
  • Difficulty urinating
  • A rapid heartbeat
  • Erectile dysfunction

All these symptoms occur as a result of the impact autonomic neuropathy has on the body’s organs. The stomach, heart, intestines, bladder, sweat glands and sex organs can all be affected.

Proximal and focal neuropathy

Proximal neuropathy causes a weakness in the thighs, legs and buttocks. Strength can leave these muscles as the nerves suffer, and it can be as severe as to limit mobility.

Focal neuropathy is very focused and can cause intense pain in one particular spot on the body, such as in the cheek or in the arm. It usually occurs just in the torso and head.

Diagnosing diabetic neuropathy

There is no single test for neuropathy, and a doctor will diagnose it based on a variety of symptoms and tests. Blood pressure, heart rate, strength, sensitivity and reflexes can all be tested to check for certain types of neuropathy.

If neuropathy is detected and diagnosed during tests, they will also be able to judge how advanced the neuropathy is and recommend ways that it can be treated.

If you have either type 1 or type 2 diabetes, you should be tested for neuropathy on an annual basis. As loss of feeling is one of the major signs of damaged nerves, you should also check your feet every day for cuts, blisters, bruises, sores and dry or cracked skin.

If you notice anything unusual – for example, a cut that is taking an unusually long time to heal – consult your doctor as soon as possible.

Treating neuropathy

Unfortunately, there is little to be done in terms of treatment, and nerve damage is often permanent. If your neuropathy is causing you pain, you may be put on course of prescription medication to help ease the pain.

People who suffer with nausea as a result of autonomic neuropathy may find that a dietician can help them to plan meals better, and focus on foods which will not have this affect. Similarly, certain diet control can reduce constipation and diarrhea.

There are also medications to combat the burning and tingling sensations that can occur, and certain foot protection methods can be undertaken to make sure that feet aren’t as vulnerable.

Preventing neuropathy

The best way to deal with neuropathy is to prevent it. Keeping blood glucose levels well controlled, combined with eating healthily, stopping smoking and having an active lifestyle, will help to prevent damage to the nervous system.