Diabetic Neuropathy Overview
Diabetic neuropathy, which you may hear called diabetic nerve pain, is diabetes-related nerve damage. It develops over time; the longer you have diabetes, the more at risk you are for diabetic neuropathy. In fact, the National Institute of Diabetes and Digestive and Kidney Diseases reports that 60% to 70% of people with either type 1 diabetes or type 2 diabetes will develop a type of diabetic nerve pain.1 There are 4 types of diabetic neuropathy: diabetic peripheral neuropathy (the most common type), proximal neuropathy, autonomic neuropathy, and focal neuropathy. Peripheral neuropathy is the most likely to cause pain, but proximal neuropathy can also cause pain. Diabetic Neuropathy Causes Even though the exact cause of diabetic neuropathies isn't fully understood, researchers in the medical community do know that poor blood glucose control (blood sugar) is related to the development of nerve damage. What they don't understand is how long-term exposure to high blood glucose levels leads to nerve damage. There is an idea that elevated blood glucose levels damage the blood vessels over time. Damaged blood vessels can't bring oxygen and nutrients to the nerves as well as they should be able to, eventually leading to nerve damage. Most likely, diabetic neuropathy develops because of a mix of factors: • Lifestyle: Smoking and excessive alcohol use can contribute to diabetic neuropathy. • Age: The longer you have diabetes, the more likely it is that you will develop diabetic neuropathy. • Nerve Injury: Your nerves can be injured because of other conditions, such as carpal tunnel syndrome, or they may be injured because of inflammation. Injured nerves may be more likely to develop diabetic neuropathy. • Autoimmune Factors: In autoimmune diseases, and type 1 diabetes is Continue reading >>
Diabetes And Foot Problems
For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot problems. you might like Diabetes can cause two problems that can affect your feet: Diabetic neuropathy. Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy." If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. The muscles of the foot may not function properly, because the nerves that make the muscles work are damaged. This could cause the foot to not align properly and create too much pressure in one area of the foot. It is estimated that up to 10% of people with diabetes will develop foot ulcers. Foot ulcers occur because of nerve damage and peripheral vascular disease. Peripheral vascular disease. Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called "peripheral vascular disease." Peripheral vascular disease is a circulation disorder that affects blood vessels away from the heart. If you have an infection that will not heal because of poor blood flow, you are at risk for developing ulcers or gangrene (the death of tissue due to a lack of blood). Continue reading >>
What Can I Do For Numb, Painful Feet And Legs?
My husband was diagnosed with diabetes almost a year ago. At first he was experiencing numbness in his feet. Over the past few months, he began having pain as well, sometimes as far up his leg as his calf. What can we do to help these symptoms? I have read that vitamin E and even flaxseed oil are good for the circulation. Would those be helpful? Continue reading >>
Diabetes-related Foot And Ankle Problems
EndocrineWeb spoke with Dr. Nere Onosode about diabetes-related foot and ankle problems. Dr. Onosode is a Doctor of Podiatric Medicine and board-qualified by the American Board of Foot and Ankle Surgery. Here, he answers the many questions of interest to people with diabetes. What are some of the common types of foot problems you see in patients with diabetes? Dr. Onosode: I tend to see underlying structural bony and soft tissue problems. These include digital contractures commonly known as hammertoe deformities. Another is hallus abducto valgus deformities—commonly called bunions. A bunion affects shoe fit and comfort when walking, and causes soft tissue problems. Frankly, anything (eg, irritation) that causes bony or soft tissue enlargement of the front part of the foot (called the forefoot) can be problematic in the diabetic population. Is there a difference in the prevalence of foot and/or ankle problems in patients with Type 1 versus Type 2 diabetes? Dr. Onosode: In my practice, Type 2 definitely tends to be more prominent than Type 1. I believe this is because patients with Type 2 diabetes are diagnosed later in life, tend to be more overweight, and have developed complications by the time they see me. The onset of Type 1 diabetes occurs in children and teenagers, and they are usually diagnosed and managed early. Do people with diabetes tend to have more foot problems than people who do not have the disease? Dr. Onosode: People whose diabetes is not properly controlled tend to have more foot problems than nondiabetics. However, having diabetes is not a sentence to developing problems with the feet! I tell patients, if you are controlling your diabetes well, checking your feet daily, seeing the right specialist—whether that is your endocrinologist, primary care Continue reading >>
Tips For Treating Diabetic Nerve Pain
Diabetes can cause long-term problems throughout your body, especially if you don’t control your blood sugar effectively, and sugar levels remain high for many years. High blood sugar can cause diabetic neuropathy, which damages the nerves that send signals from your hands and feet. Diabetic neuropathy can cause numbness or tingling in your fingers, toes, hands, and feet. Another symptom is a burning, sharp, or aching pain (diabetic nerve pain). The pain may be mild at first, but it can get worse over time and spread up your legs or arms. Walking can be painful, and even the softest touch can feel unbearable. Up to 50 percent of people with diabetes may experience nerve pain. Nerve damage can affect your ability to sleep, decrease your quality of life, and can also cause depression. Damaged nerves can’t be replaced. However, there are ways that you can prevent further damage and relieve your pain. First, control your blood sugar so the damage doesn’t progress. Talk to your doctor about setting your blood sugar goal, and learn to monitor it. You may be asked to lower your blood sugar before meals to 70 to 130 milligrams per deciliter (mg/dL) and your blood sugar after meals to less than 180 mg/dL. Use diets, exercise, and medications to decrease your blood sugar to a healthier range. Monitor other health risks that can worsen your diabetes, such as your weight and smoking. Ask your doctor about effective ways to lose weight or quit smoking, if necessary. Your doctor might suggest trying an over-the-counter pain reliever, such as acetaminophen (Tylenol), aspirin (Bufferin), or ibuprofen (Motrin IB, Advil), which are available without a prescription but can cause side effects. Use a low dose for a short time to control your symptoms. Other options exist for stronger Continue reading >>
Diabetes And Foot Problems
Foot problems are common in people with diabetes. You might be afraid you’ll lose a toe, foot, or leg to diabetes, or know someone who has, but you can lower your chances of having diabetes-related foot problems by taking care of your feet every day. Managing your blood glucose levels, also called blood sugar, can also help keep your feet healthy. How can diabetes affect my feet? Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected. Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a bad infection never heals. The infection might lead to gangrene. Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg. A surgeon may perform an amputation to prevent a bad infection from spreading to the rest of your body, and to save your life. Good foot care is very important to prevent serious infections and gangrene. Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcot’s foot. Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a “rocker bottom.” What can I do to keep my feet healthy? Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should inclu Continue reading >>
Diabetes And Foot Problems Treatment And Complications
Diabetes and foot problems facts Two main conditions, peripheral artery disease (PAD) and peripheral neuropathy, are responsible for the increased risk of foot problems in people with diabetes. Symptoms and signs of diabetic foot problems arise due to the decreased sensation from nerve damage as well as the lack of oxygen delivery to the feet caused by vascular disease. Diabetic foot problems also include bunions, corns, calluses, hammertoes, fungal infections, dryness of the skin, and ingrown toenails. These problems are not specific to diabetes, but may occur more commonly due to the nerve and vascular damage caused by diabetes. Treatment depends on the exact type of foot problem. Surgery or even amputation may be required for some cases. Gangrene (dry gangrene) is tissue death due to absence of blood circulation. It can be life threatening if bacterial infection develops (wet gangrene). Many diabetes-related foot problems can be prevented by good control of blood sugar levels combined with appropriate care of the feet. How can diabetes cause foot problems? Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral nerves that can result in problems in the legs and feet. Two main conditions, 1) peripheral artery disease (PAD), and 2) peripheral neuropathy are responsible for the increased risk of foot problems in people with diabetes. Peripheral artery disease (PAD), sometimes referred to as peripheral vascular disease (PVD), means that there is narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain. This is sometimes referred to as "hardening" of the arteries. Diabetes is a known risk factor for developing peripheral artery disease. In addition to pain in the calves during exercise (medically known as intermitte Continue reading >>
Diabetic Foot Pain
by Kenneth B. Rehm, DPM Includes photo of Dr. Kenneth B. Rehm, DPM Diabetes is one of the most common reasons people seek relief for painful feet. With diabetes, four types of foot problems may arise in the feet. Nerve Problems due to Diabetes The most common contributor to diabetic foot pain is a nerve problem called Peripheral Neuropathy. This is where the nerves are directly affected by the disease process. There are basically three types of peripheral neuropathy: sensory, motor, and autonomic neuropathy. A large percentage of pain diabetic patients complain of is due to sensory neuropathy. This can show up as "sensitive pain," where the amount of pain is not proportional to the amount of insult that is causing it. For instance, just touching the skin or putting a sheet over your feet in bed could be painful. This can be present at the same time as numbness in the feet. Sensory neuropathy symptoms can include burning, tingling or a stabbing pain. Relief is foremost on someone's mind when painful neuropathy has raised its ugly head. The first thing to do is to check your blood sugar for the past several weeks to see if there has been a trend toward high blood sugar (Editor's Note: The A1c test is traditionally employed to determine this, and should be repeated about every three months.) Persistent high blood sugar can contribute to this type of pain. Massaging your feet with a diabetic foot cream, or using a foot roller, often takes the edge off the pain. Vitamin B preparations are often recommended; and there are a variety of prescription medications that do work. Using cushioned, supportive shoes and foot support inserts is always needed to protect the feet from the pounding, rubbing and irritating pressures that contribute to neuropathic pain. Motor neuropathy can Continue reading >>
How To Deal With Nerve Pain If You Have Diabetes
If you have diabetes , you know it well: Too much sugar isn’t good for you. People whose blood sugar is too high or difficult to control are more susceptible to cardiovascular disease, kidney damage, eye problems and other complications, including nerve damage (diabetic neuropathy). Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy “High blood sugar is toxic to your nerves,” says Robert Bolash, MD , a specialist in Cleveland Clinic’s Department of Pain Management. “When a nerve is damaged, you may feel tingling, pins and needles, burning or sharp, stabbing pain.” Diabetic neuropathy typically starts in your toes, feet or ankles and creeps up your body as the condition worsens, he says. However, nerve damage also can affect your hands and wrists as well as your heart, digestive system, sex organs and more. Up to 70 percent of people with diabetes have some kind of neuropathy , reports the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) . “Anyone with diabetes can get nerve damage at any time,” says Dr. Bolash. “It’s most common in people whose blood sugar is poorly controlled and those who have had diabetes a long time.” According to the NIDDK, the highest rates of neuropathy are among people who have had diabetes 25 years or longer. To avoid getting diabetic neuropathy, control your blood sugar, keeping it as close to nondiabetic levels as possible, advises Dr. Bolash. The bad news about diabetic neuropathy is that it’s tough to reverse. It also can cause serious problems, especially in your feet. If you don’t feel blisters, sores or other foot injuries and don’t promptly care for them, you Continue reading >>
Why Do Your Feet Hurt?
In the days before modern medicine, someone who lived long enough with diabetes may have had one or both legs amputated. I assumed it did not happen anymore, until I read about people with diabetes who have ignored high blood sugar levels and developed complications requiring amputations. It seemed impossible that this could still be happening. Then the pain and numbness in my own feet sent me looking for answers. What caused it, and what could I do about it? I learned that the path from high blood sugar to foot ulcers and amputations often goes through a condition called peripheral neuropathy, the medical term for nerve damage in the hands, feet, arms, and legs that often causes pain and numbness. Diabetes and nerve damage High blood sugar damages blood vessels. One doctor described the extra glucose floating in the blood of someone with diabetes as similar to bits of glass scraping along the walls of veins and arteries. The tiniest blood vessels are easily damaged. That is why eyes, feet, and kidneys are so vulnerable, showing signs of blood vessel damage, sometimes even before a person is aware he has diabetes. Fingers and toes can become numb or overly sensitive when the blood vessels that supply the nerves are hurt. The longest nerves in your body run down your spine into your feet, ending at your toes. This makes feet an easy target for damage from peripheral neuropathy. Feet with nerve damage Because of diabetes we must care more about issues like foot ulcers, infections, ingrown nails, toenail fungus, and sores. The greatest enemy to our feet is numbness, because pain is the thing that warns us something is wrong. Peripheral neuropathy may make your feet more sensitive to touch while at the same time the numbness it may cause can mask problems like hot spots tha Continue reading >>
Why Does Type 2 Diabetes Cause Your Feet To Go Numb?
Numbness in the feet is a symptom of neuropathy or nerve damage, one of the most common long-term complications of type 2 diabetes. Neuropathy is caused by poor blood sugar control that persists over a long period of time. “The higher the blood sugars and the longer they stay high, the greater the chance of the person developing neuropathy,” says Joel Zonszein, MD, director of the Clinical Diabetes Center at the University Hospital of the Albert Einstein College of Medicine, Montefiore Health System in the Bronx, New York. “The nerves that get affected by high sugars tend to be the longest nerves in the body,” explains Dr. Zonszein. These nerves go from the spine to the toes, which is why the feet get affected before the arms or hands. Diabetic neuropathy also tends to be bilateral. “Both feet will be affected equally,” he says. If blood sugar remains poorly controlled, it can lead to serious complications. In the feet, diabetic neuropathy can not only cause numbness but pain and injuries. It can change the shape of your feet, deforming them so they no longer fit into regular shoes. It can also dry out and damage your skin, cause calluses and ulcers on your feet, and interfere with circulation. The numbness also makes it hard to tell if there is a cut or injury which can increase your risk of infections and amputation. People with diabetes are also at an increased risk for amputation. In 2010, approximately 73,000 non-traumatic lower-limb amputations were performed on adults (20 years or older) diagnosed with diabetes, according to the American Diabetes Association. The good news is that most amputations are preventable when you manage your diabetes well, take good care of your feet, and wear proper footwear. If you have circulatory problems or you’ve alre Continue reading >>
Can Diabetic Neuropathy Be Reversed?
Diabetic neuropathy refers to nerve damage caused by diabetes. Neuropathy is a common condition impacting 60 to 70 percent of adults with diabetes. However, it mainly concerns those with uncontrolled blood sugar levels or those who have had diabetes for more than 25 years. The nerve damage caused by diabetic neuropathy is irreversible but there are ways to lessen symptoms and prevent further harm. Contents of this article: What is diabetic neuropathy? Diabetic neuropathy is a family of progressive nerve disorders related to type 1 and 2 diabetes. Although research is still taking place on this type of nerve damage, doctors think that blood sugars may damage nerve cells by impairing nerve fibers and reducing or confusing signaling. However, nerve damage is likely to be caused by a combination of factors, such as how the immune system functions, genetics, smoking, or alcohol use. Neuropathy can cause a range of symptoms, including pain, loss of sensation, numbness, tingling, and muscle weakness. Although neuropathy can occur wherever there are nerves, it tends to affect the legs and feet. Those with diabetic neuropathy tend to: have poor blood sugar control be over the age of 40 be overweight or obese have had diabetes for at least 10 to 25 years, depending on the severity Types Diabetic neuropathy is typically divided into four categories depending on which nerves are affected. Peripheral neuropathy Nerve damage that impacts the ability of the peripheral nerves to sense things, such as temperature and touch. Peripheral neuropathy most commonly affects the arms, hands, legs, feet, and toes, often causing pain or loss of feeling. It is the most common form of diabetic neuropathy. Proximal neuropathy Nerve damage resulting in pain in the hips, thighs, pelvis, and buttocks. Continue reading >>
Diabetic Foot Care Article
A A A Diabetes mellitus (DM) represents several diseases in which high blood glucose levels over time can damage the nerves, kidneys, eyes, and blood vessels. Diabetes can also decrease the body's ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system is likely. Foot problems commonly develop in people with diabetes and can quickly become serious. With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired. These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot. Sores may develop. Damage to blood vessels and impairment of the immune system from diabetes make it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur. These infections can develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life-threatening. People with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur. Although treatment for diabetic foot problems has improved, prevention - including good control of blood sugar level - remains the best way to prevent diabetic complications. People with diabetes should learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problems. They should also l Continue reading >>
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 >>
How Can Diabetes Affect The Feet?
People with diabetes are prone to foot problems caused by prolonged periods of high blood sugar. There are two main foot problems, each of which can have serious complications. Diabetes is a disease where the body cannot produce insulin or cannot use it effectively. Insulin is the hormone that is responsible for helping the cells take in sugar to use for energy. When this does not happen properly, the levels of sugar in the blood can become too high. Prolonged periods of high sugar levels in the blood can wreak havoc on many areas of the body, including the feet. Diabetic foot problems The two main foot problems that affect people with diabetes are: Diabetic neuropathy Over time, diabetes can cause nerve damage that makes it hard for people with diabetes to feel sensation in their extremities. The condition also makes it difficult for a person to feel an irritation on their foot or notice when their shoes are rubbing. This lack of sensation and awareness leads to an increase in the risk of cuts, sores, and blisters developing. Peripheral vascular disease Diabetes leads to changes in the blood vessels, including arteries. In peripheral vascular disease, fatty deposits block these vessels beyond the brain and heart. It tends to affect the blood vessels leading to and from the extremities, reducing blood flow to the hands and feet. Reduced blood flow can lead to pain, infection, and slow healing wounds. Severe infections may lead to amputation. Symptoms Symptoms may vary from person to person and may depend on what issues a person is experiencing at the time. Symptoms of diabetic foot problems can include the following: loss of feeling numbness or tingling sensation blisters or other wounds without painful skin discoloration skin temperature changes red streaks wounds with Continue reading >>