What Is Diabetic Neuropathy?
Diabetic neuropathy refers to the damage that affects the nerves of the body in people who have diabetes. It is a progressive disease, and symptoms worsen over a number of years. People who do not control their blood sugar levels and those who have high blood pressure, high blood cholesterol, or who are overweight are more susceptible. Neuropathy can affect any nerve in the body, but especially the nerves of the ganglia, the outside of the skull, the spinal cord, and those that impact the functioning of fundamental organs, such as the heart, bladder, intestines, and stomach. Problems can occur in the nerves that control the periphery, or outside, of the body, such as the feet and hands, those that control the automatic functions of the body, such as heart rate and digestion, or just one or a small group of nerves. Different nerves are affected in different ways. Around 60 percent to 70 percent of people with diabetes develop diabetic neuropathy, but symptoms may take 10 to 20 years to appear. The highest rates of neuropathy are found in patients who have been diagnosed with diabetes for 25 years or more. Types of diabetic neuropathy There are four main types of neuropathy, and they are: Peripheral neuropathy, which affects the feet and hands, is the most common form of diabetic neuropathy Autonomic neuropathy, affecting the nerves that control the involuntary functions of the body, like digestion Proximal neuropathy, which affects the legs Focal neuropathy, in which damage can occur in any nerve or any group of nerves. The symptoms of neuropathy depend on the nerves affected. A range of problems is associated with diabetic neuropathy. These include cardiovascular issues, intestinal problems such as constant diarrhea, nausea, and vomiting, weakness, muscle pain, and para Continue reading >>
Diabetic Peripheral Neuropathy And Depressive Symptoms
The association revisited Abstract OBJECTIVE—We examined the association between severity of diabetic peripheral neuropathy and depressive symptoms and investigated the potential mediators of this association. RESEARCH DESIGN AND METHODS—The Hospital Anxiety and Depression Scale (HADS) was used to assess depressive symptoms in 494 patients (mean age 62 years; 70% male; 72% type 2 diabetic) with diabetic neuropathy diagnosed by the Neuropathy Disability Score (NDS) and the Vibration Perception Threshold (VPT). Diabetic neuropathy symptoms, activities of daily living (ADLs), and social self-perception were measured by the neuropathy and foot ulcer–specific quality-of-life instrument, NeuroQoL; perceptions of diabetic neuropathy symptom unpredictability and the lack of effective treatment were assessed by the revised Illness Perception Questionnaire. RESULTS—Both the NDS and VPT were significantly associated with the HADS after controlling for demographic and disease variables. Although diabetic neuropathy symptoms mediated this association, with unsteadiness being most strongly associated with HADS, the relationship between foot ulceration and depression was nonsignificant. The association between diabetic neuropathy symptoms and HADS was partially mediated by two sets of psychosocial variables: 1) perceptions of diabetic neuropathy symptom unpredictability and the lack of treatment control and 2) restrictions in ADLs and changes in social self-perception. CONCLUSIONS—These findings establish the association between diabetic neuropathy and depressive symptoms and identify potential targets for interventions to alleviate depressive symptoms in persons affected by diabetic peripheral neuropathy. Diabetic peripheral neuropathy is common, affecting up to 50% of pati Continue reading >>
Diabetic Neuropathy
Diabetic neuropathies are nerve damaging disorders associated with diabetes mellitus. These conditions are thought to result from a diabetic microvascular injury involving small blood vessels that supply nerves (vasa nervorum) in addition to macrovascular conditions that can accumulate in diabetic neuropathy. Relatively common conditions which may be associated with diabetic neuropathy include third, fourth, or sixth cranial nerve palsy[1]; mononeuropathy; mononeuropathy multiplex; diabetic amyotrophy; a painful polyneuropathy; autonomic neuropathy; and thoracoabdominal neuropathy. Signs and symptoms[edit] Illustration depicting areas affected by diabetic neuropathy Diabetic neuropathy affects all peripheral nerves including sensory neurons, motor neurons, but rarely affects the autonomic nervous system. Therefore, diabetic neuropathy can affect all organs and systems, as all are innervated. There are several distinct syndromes based on the organ systems and members affected, but these are by no means exclusive. A patient can have sensorimotor and autonomic neuropathy or any other combination. Signs and symptoms vary depending on the nerve(s) affected and may include symptoms other than those listed. Symptoms usually develop gradually over years. Symptoms may include the following: Trouble with balance Numbness and tingling of extremities Dysesthesia (abnormal sensation to a body part) Diarrhea Erectile dysfunction Urinary incontinence (loss of bladder control) Facial, mouth and eyelid drooping Vision changes Dizziness Muscle weakness Difficulty swallowing Speech impairment Fasciculation (muscle contractions) Anorgasmia Retrograde ejaculation (in males) Burning or electric pain Pathogenesis[edit] The following factors are thought to be involved in the development of dia Continue reading >>
Diabetic Peripheral Neuropathy
What Is Diabetic Peripheral Neuropathy? Diabetic neuropathy is nerve damage caused by diabetes. When it affects the arms, hands, legs and feet, it is known as diabetic peripheral neuropathy. Diabetic peripheral neuropathy is different from peripheral arterial disease (poor circulation), which affects the blood vessels rather than the nerves. Three different groups of nerves can be affected by diabetic neuropathy: Sensory nerves, which enable people to feel pain, temperature and other sensations Motor nerves, which control the muscles and give them their strength and tone Autonomic nerves, which allow the body to perform certain involuntary functions, such as sweating Diabetic peripheral neuropathy does not emerge overnight. Instead, it usually develops slowly and worsens over time. Some patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase the likelihood of having diabetic neuropathy. The loss of sensation and other problems associated with nerve damage make a patient prone to developing skin ulcers (open sores) that can become infected and may not heal. This serious complication of diabetes can lead to loss of a foot, a leg or even a life. Causes The nerve damage that characterizes diabetic peripheral neuropathy is more common in patients with poorly managed diabetes. However, even patients living with diabetes who have excellent blood sugar (glucose) control can develop diabetic neuropathy. There are several theories as to why this occurs, including the possibilities that high blood glucose or constricted blood vessels produce damage to the nerves. As diabetic peripheral neuropathy progresses, various nerves are affected. These damaged nerves can cause problems that encourage development of ulcers. Fo Continue reading >>
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. 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 Continue reading >>
Peripheral Neuropathy And Diabetes
Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, or hands. It is the most common complication of diabetes. About 60% to 70% of all people with diabetes will eventually develop peripheral neuropathy, although not all suffer pain. Yet this nerve damage is not inevitable. Studies have shown that people with diabetes can reduce their risk of developing nerve damage by keeping their blood sugar levels as close to normal as possible. What causes peripheral neuropathy? Chronically high blood sugar levels damage nerves not only in your extremities but also in other parts of your body. These damaged nerves cannot effectively carry messages between the brain and other parts of the body. This means you may not feel heat, cold, or pain in your feet, legs, or hands. If you get a cut or sore on your foot, you may not know it, which is why it's so important to inspect your feet daily. If a shoe doesn't fit properly, you could even develop a foot ulcer and not know it. The consequences can be life-threatening. An infection that won't heal because of poor blood flow causes risk for developing ulcers and can lead to amputation, even death. This nerve damage shows itself differently in each person. Some people feel tingling, then later feel pain. Other people lose the feeling in fingers and toes; they have numbness. These changes happen slowly over a period of years, so you might not even notice it. Because the changes are subtle and happen as people get older, people tend to ignore the signs of nerve damage, thinking it's just part of getting older. But there are treatments that can help slow the progression of this condition and limit the damage. Talk to your doctors Continue reading >>
Diabetic Neuropathydiabetic Neuropathy Symptoms, Causes, Diagnosis, And Treatment
Diabetic neuropathy definition and facts Diabetes is thought to damage nerves as a result of prolonged elevated levels of blood glucose. Peripheral neuropathy most commonly causes: Autonomic neuropathy causes symptoms related to dysfunction of an organ system, such as: Diagnosis of diabetic neuropathy is usually done by a clinical exam. There is no cure for diabetic neuropathy, but treatments are available to manage the symptoms. Diabetic nerve pain may be controlled by medications such as tricyclic antidepressants, duloxetine (Cymbalta), or certain antiseizure medications. Keeping tight control of blood sugar levels is the best way to prevent diabetic neuropathy and other complications of diabetes. Diabetic Peripheral Neuropathy: Improve Diabetes Nerve Pain What are the symptoms and signs of diabetic neuropathy? The symptoms and signs of diabetic neuropathy depend upon the type of neuropathy that is present. Signs and symptoms can also vary in severity among affected people. Signs and symptoms of diabetic peripheral neuropathy include: Numbness or tingling of the feet and lower legs Pain or burning sensations Loss of sensation in the feet or lower legs Sometimes, but less commonly, these symptoms can occur in the hands or arms Signs and symptoms of diabetic proximal neuropathy include: Pain, usually on one side, in the hips, buttocks, or thighs Signs and symptoms of diabetic autonomic neuropathy depend upon the organ system that is involved and can include: Feeling full after eating a small amount Inability to empty the bladder completely Decrease in vaginal lubrication in women Rapid resting heartbeat Signs and symptoms of diabetic focal neuropathy also depend upon the location of the affected nerve. The symptoms can appear suddenly. It usually does not cause a long t Continue reading >>
Diabetic Peripheral Neuropathy
From the Editor: This article first appeared in the Voice of the Diabetic, Volume 18, Number 4, Fall 2003. It has been updated to reflect developments in treatment of diabetic neuropathy and changed Website links. Diabetic neuropathy is or should be of significant interest to all diabetics. Aside from causing pain and often being a major contributor to amputation, it prevents some diabetics from learning or reading Braille. Understanding this complication should motivate many diabetics to work just that much harder to keep their disease under good control. Here is some useful information: What is Neuropathy? Neuropathy is a general term for physical damage to or impairment of the human nervous system. It has many causes and many symptoms. Because a long period with elevated blood glucose can damage nerve fibers, diabetes is one of several major causes of neuropathy (others being AIDS and multiple sclerosis.) The Centers for Disease Control suggests up to 70 percent of diabetics may have measurable neuropathy, though a number of other diseases (and some medications) can also cause this condition. The presence of unexplained neuropathy is a warning flag that you need to find out where these symptoms are coming from. "Diabetic neuropathy occurs in both type 1 and type 2 diabetes," says InteliHealth, an Internet magazine now affiliated with Harvard Medical School, "and it is most common in those whose blood glucose levels have been poorly controlled. Although diabetic neuropathy can occur in patients who have had diabetes for a short time, it is most likely to affect those who have been diabetic for more than a decade, especially those over age forty. Diabetics who smoke are especially at risk." The human nervous system is enormously complex. The peripheral nerves carry inf Continue reading >>
Diabetes And Peripheral Neuropathy
Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, and hands. Neuropathy linked with diabetes is also called diabetic polyneuropathy. It is a very common complication of diabetes. The NHS says the longer you have diabetes, the greater your chances are of developing diabetic polyneuropathy. It estimates that around half of all people who have had diabetes for 25 years or more have diabetic polyneuropathy. Studies have shown that people with diabetes can reduce or delay their risk of developing nerve damage by keeping their blood sugar levels as close to normal as possible. What causes peripheral neuropathy? Chronically high blood sugar levels damage nerves not only in your extremities but also in other parts of your body. These damaged nerves cannot effectively carry messages between the brain and other parts of the body. This means you may not feel heat, cold or pain in your feet, legs, or hands. If you get a cut or sore on your foot, you may not know it, which is why it's so important to inspect your feet daily. If a shoe doesn't fit properly, you could even develop a foot ulcer and not know it. An infection that will not heal because of poor blood flow increases the risk of developing ulcers and can lead to amputation, even death. This nerve damage shows itself differently in each person. Some people feel tingling, then later feel pain. Other people lose the feeling in fingers and toes - they have numbness. These changes happen slowly over a period of years, so you might not even notice it. Because it happens as people get older, experts say they tend to ignore the little tingles or subtle loss of sensation that is occurring - the signs of nerve dama Continue reading >>
What Is Diabetic Nerve Pain?
If you have diabetes and shooting, burning, pins and needles pain in your feet or hands, you could have painful diabetic peripheral neuropathy—also known as diabetic nerve pain. It is a common complication of diabetes. The most common cause is poorly controlled blood sugar over time. Diabetic nerve pain can take years to develop. In the early stages, you may have no signs at all, and then only start to feel a tingling or numbness in your feet. As it progresses, you may also feel the pain in your hands and it is often worse at night. This means that your nerves may be damaged for a long time before you experience painful symptoms. Nerve damage can’t be reversed, but controlling your blood sugar can help prevent further damage. Talk to your doctor if you experience any symptoms of diabetic nerve pain. Symptoms of diabetic nerve pain These are some of the most common symptoms of diabetic nerve pain: Shooting Burning Pins and needles Numbness Electric shock-like Throbbing Tingling Stinging Stabbing Radiating Sensitivity to touch How is diabetic nerve pain different from other pain? There are two types of pain—muscle pain or nerve pain. Both types of pain are your body’s way of telling you that something is wrong but each has its own cause, symptoms, and management. Muscle pain is a "protective" form of pain. It is caused by something specific like an injury or inflammation. The nerves in the injured muscle or joint send electric signals to the brain as a warning that damage has occurred and the activity you’re doing is causing harm. If you limit or stop the harmful activity, muscle pain can get better over time. Nerve pain is a "non-protective" form of pain. It occurs when your nerves are damaged by an injury or disease, such as diabetes. Your nerves send extra el Continue reading >>
Symptoms Of Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy is a condition caused by long-term high blood sugar levels, which causes nerve damage. Some people will not have any symptoms. But for others symptoms may be debilitating. Between 60 and 70 percent of people with diabetes have some form of neuropathy, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Peripheral neuropathy, the most common form of diabetic neuropathy, affects the legs, feet, toes, hands, and arms. Many people do not know that they have diabetes. People unaware of their diabetes may not know what’s causing some of the unusual sensations they’re experiencing. Nerve damage is the result of high levels of blood glucose over long periods of time. It isn’t entirely clear why high glucose levels damage nerves. A number of factors may play a role in nerve fiber damage. One possible component is the intricate interplay between the blood vessels and nerves, according to the Mayo Clinic. Other factors include high blood pressure and cholesterol levels and nerve inflammation. Diabetic peripheral neuropathy usually first appears in the feet and legs, and may occur in the hands and arms later. A common symptom of diabetic peripheral neuropathy is numbness. Sometimes you may be unable to feel your feet while walking. Other times, your hands or feet will tingle or burn. Or it may feel like you’re wearing a sock or glove when you’re not. Sometimes you may experience sudden, sharp pains that feel like an electrical current. Other times, you may feel cramping, like when you’re grasping something like a piece of silverware. You also may sometimes unintentionally drop items you’re holding as a result of diabetic peripheral neuropathy. Walking with a wobbly motion or even losing your balance can res Continue reading >>
Nerve Damage (diabetic Neuropathies)
What are diabetic neuropathies? Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight. What causes diabetic neuropathies? The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors: metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves autoimmune factors that cause inflammation in nerves mechanical injury to nerves, such as carpal tunnel syndrome inherited traits that increase susceptibility to nerve disease lifestyle factors, such as smoking or alcohol use What are the symptoms of diabetic neuropathies? Symptoms depend on the type of neuropathy and which Continue reading >>
Diabetic Neuropathy
Print Overview Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet. Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal. Diabetic neuropathy is a common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle. Symptoms There are four main types of diabetic neuropathy. You may have just one type or symptoms of several types. Most develop gradually, and you may not notice problems until considerable damage has occurred. The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and which nerves are affected. Peripheral neuropathy Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include: Numbness or reduced ability to feel pain or temperature changes A tingling or burning sensation Sharp pains or cramps Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing Muscle weakness Loss of reflexes, especially in the ankle Loss of balance and coordination Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain Autonomic neuropathy The autonomic nervous system controls your hea Continue reading >>
Nerve Damage (diabetic Peripheral Neuropathy)
Diabetic peripheral neuropathy is a long-term complication of diabetes. Exposure to high blood glucose levels over an extended period of time causes damage to the peripheral nerves – the nerves that go to the arms, hands, legs, and feet. Symptoms of diabetic peripheral neuropathy Although diabetic peripheral neuropathy can occur in many places in the body, the most common symptoms are abnormal sensations in the toes and feet, including: Sharp, shooting pains Burning Tingling A feeling of being pricked with pins Throbbing Numbness (not able to properly feel pain, heat, or cold) Diabetic peripheral neuropathy increases the risk for foot ulcers and amputation. Due to nerve damage in their feet and toes, people with diabetes who have diabetic peripheral neuropathy often do not notice minor cuts, sores, or blisters in these areas. If left untreated, these small wounds can easily become infected, lead to gangrene, and may eventually require amputation of the affected area. Risk factors for diabetic peripheral neuropathy Risk factors for diabetic peripheral neuropathy include: High blood glucose (sugar) levels Elevated triglycerides Excess body weight Smoking High blood pressure Diagnosing diabetic peripheral neuropathy in the feet Your doctor or foot care specialist can test for diabetic peripheral neuropathy by lightly pressing a thin nylon rod (10-gram monofilament) to different areas of your foot (in particular, your big toe) or by using the 128-Hz tuning fork on the back of the big toe to determine if you can feel it. These are easy and pain-free tests. When to screen for diabetic peripheral neuropathy For type 1 diabetes Because diabetic peripheral neuropathy is uncommon within the first five years after onset of type 1 diabetes, annual screening for diabetic periphera Continue reading >>
Diabetic Neuropathy Symptoms
The symptoms of diabetic neuropathy depend on what type of neuropathy you have. Symptoms are dependent on which nerves have been damaged. In general, diabetic neuropathy symptoms develop gradually; they may seem like minor and infrequent pains or problems at first, but as the nerves become more damaged, symptoms may grow. Don’t overlook mild symptoms. They can indicate the beginning of neuropathy. Talk to your doctor about anything you notice—such as any pain, numbness, weakness, or tingling—even if it seems insignificant. Your pain may mean the control of your diabetes could be improved, which will can help slow down the progression of your neuropathy. Pain and numbness are also important warning signs to take very good care of your feet, so you can avoid wounds and infections that can be difficult to heal and even raise risk for amputation. 1 Peripheral Neuropathy Symptoms Peripheral neuropathy affects nerves leading to your extremities—the feet, legs, hands, and arms. The nerves leading to your feet are the longest in your body, so they are the most often affected nerves (simply because there’s more of them to be damaged). Peripheral neuropathy is the most common form of diabetic neuropathy. Peripheral neuropathy symptoms include: Pain Burning, stabbing or electric-shock sensations Numbness (loss of feeling) Tingling Muscle weakness Poor coordination Muscle cramping and/or twitching Insensitivity to pain and/or temperature Extreme sensitivity to even the lightest touch Symptoms get worse at night. 2, 3 Autonomic Neuropathy Symptoms The autonomic nervous system is in charge of the "involuntary" functions of your body. It keeps your heart pumping and makes sure you digest your food right—without you needing to think about it. Autonomic neuropathy symptoms i Continue reading >>
