diabetestalk.net

What Is Diabetic Neuropathy Pain?

What Can I Do For Numb, Painful Feet And Legs?

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 >>

What Is Diabetic Neuropathy?

What Is Diabetic Neuropathy?

Diabetes can harm your nerves. That damage, called neuropathy, may be painful. It can happen in several ways, and they all seem to be related to blood sugar levels being too high for too long. To prevent it, work with your doctor to manage your blood sugar. You may hear your doctor mention the four types of diabetes-related neuropathy: peripheral, autonomic, proximal, and focal. Peripheral Neuropathy This type usually affects the feet and legs. Rare cases affect the arms, abdomen, and back. Symptoms include: Tingling Numbness (which may become permanent) Burning (especially in the evening) Pain Early symptoms usually get better when your blood sugar is under control. There are medications to help manage the discomfort. What you should do: Check your feet and legs daily. Use lotion on your feet if they're dry. Take care of your toenails. Ask your doctor if you should go to a podiatrist. Wear shoes that fit well. Wear them all the time, so your feet don't get injured. Autonomic Neuropathy This type usually affects the digestive system, especially the stomach. It can also affect the blood vessels, urinary system, and sex organs. In your digestive system: Symptoms include: Bloating Diarrhea Constipation Heartburn Nausea Vomiting Feeling full after small meals What you should do: You may need to eat smaller meals and take medication to treat it. In blood vessels: Symptoms include: Blacking out when you stand up quickly Faster heartbeat Dizziness Low blood pressure Nausea Vomiting Feeling full sooner than normal If you have it: Avoid standing up too quickly. You may also need to wear special stockings (ask your doctor about them) and take medicine. In Men: Symptoms include: He may not be able to have or keep an erection, or he may have “dry” or reduced ejaculations. What Continue reading >>

Diabetic Neuropathy Overview

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 >>

Painful Diabetic Neuropathy: A Management-centered Review

Painful Diabetic Neuropathy: A Management-centered Review

Abstract IN BRIEF Painful diabetic neuropathy is a common complication of diabetes and can affect many aspects of life and severely limit patients' daily functions. This article reviews the diagnosis, prevention, and management of painful diabetic neuropathy. This condition can be difficult to treat, which frustrates both providers and patients. Commonly used agents, including the recently approved duloxetine and pregabalin, are reviewed, and their effective dose ranges, titration schemes, contraindications, and recommended monitoring are discussed. Background Neuropathy is a common complication of diabetes, affecting up to 50% of patients.1-5 A consensus statement produced by an international meeting on the diagnosis and management of diabetic neuropathy defined it as “the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes.”6 There are many types of neuropathy with a variety of clinical presentations. This article focuses on one phenotype of neuropathy: painful diabetic neuropathy (PDN). A review of the epidemiology, risk factors, prevention, diagnosis, and management of PDN is presented. This review will focus on a discussion of the myriad agents used in the treatment of PDN. The efficacy, dose, and duration for an appropriate therapeutic trial, contraindications, adverse effects, and monitoring parameters of each agent used in the treatment of PDN will be discussed. THE CLINICAL PROBLEM Case Study 1 A 52-year-old white man presents with lower-extremity pain. The pain is bilateral and is described as sharp and needlelike. The pain increases when he stands. He also experiences pain with any touch, including fabric, on his skin. The pain has been present for ∼ 6 months and is not relieved w Continue reading >>

Diabetic Neuropathy: Causes And Symptoms

Diabetic Neuropathy: Causes And Symptoms

Diabetic peripheral neuropathy—DPN for short—is diabetes-related damage to nerves that sit near the surface of your skin. DPN usually affects the feet and the hands, but can also harm nerves in arms and legs. Approximately 50 percent of people with type 2 diabetes and 20% of those with type 1 diabetes develop this kind of nerve damage.1 DPN can be extremely painful—or cause numbness so that you have little feeling, especially in your feet. DPN damages two different types of nerves close to the surface of your skin. DPN can affect small nerves that protect your body by sending signals about pain and temperature changes to your brain. This condition can also attack large nerves that detect touch, pressure and help you keep your balance. 2 Symptoms are different for each type. Most people with DPN have damage to both types of nerves. DPN usually affects extremities—feet, hands, legs and arms—where nerve fibers are the longest and most numerous. 3 Causes Experts are still investigating exactly how diabetes harms and kills these nerve cells. “The causes remain unknown,” the American Diabetes Association noted in a definitive 2017 review. One thing is certain: The conventional wisdom—that high blood sugar is the cause—is just part of the story. New research is revealing a bigger cast of culprits. These include high cholesterol, high triglycerides (another blood fat), high blood pressure, obesity and smoking, according to a British research report in a widely-cited 2005 study that tracked 1,172 people with diabetes for seven years. 4 The threats are major: Obesity and high triglycerides each doubled risk in people with diabetes in a 2013 University of Utah study of 218 people with type 2 diabetes. 5 Smoking increased risk by as much as 42% in a 2015 Harvard M Continue reading >>

Diabetic Neuropathy

Diabetic Neuropathy

Diabetes is the most common cause of neuropathy. Half of all people with diabetes will develop neuropathy. The nerves of the feet are most commonly affected by diabetic neuropathy. The feet are usually numb, although many people also experience significant discomfort and pain. Most people with diabetic neuropathy are unaware that they have nerve damage, until it is picked up on routine screening by their doctor or when they develop complications. Although there is no cure, early diagnosis and treatment can improve quality of life and reduce the risk of further complications. On this page: Neuropathy means damage to the nerves of the peripheral nervous system. Diabetes is the most common cause of neuropathy. It most commonly affects the nerves to the feet and hands, but any nerves can be involved, including those that control internal organs (autonomic nerves). Up to half of all people with diabetes develop neuropathy during the course of their disease. There is no cure. Management aims to ease symptoms and reduce the risk of further complications. Symptoms of diabetic neuropathy Most people with diabetic neuropathy are unaware that they have nerve damage, until it is picked up on routine screening by their doctor. Typical symptoms vary from person to person, but may include one or more of numbness, pins and needles, tingling, discomfort, or weakness, which usually begin in both feet and spread symmetrically up the legs (like stockings). About half of those people with diabetic neuropathy experience significant pain in their feet and increased sensitivity to painful stimuli (known as neuropathic pain or painful neuropathy).Neuropathic pain is often worse at night, and can seriously disrupt sleep patterns. These symptoms can have a major effect on health and wellbeing bec Continue reading >>

Diabetic Neuropathydiabetic Neuropathy Symptoms, Causes, Diagnosis, And Treatment

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 >>

Nerve Damage (diabetic Neuropathies)

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 Treatment & Management: Approach Considerations, Glycemic Control, Diabetic Neuropathic Pain Management

Diabetic Neuropathy Treatment & Management: Approach Considerations, Glycemic Control, Diabetic Neuropathic Pain Management

Diabetic NeuropathyTreatment & Management Author: Dianna Quan, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Management of diabetic neuropathy should begin at the initial diagnosis of diabetes. The primary care physician needs to be alert for the development of neuropathyor even its presence at the time of initial diabetes diagnosisbecause failure to diagnose diabetic polyneuropathy can lead to serious consequences, including disability and amputation. [ 67 , 68 , 69 , 70 ] Consider any patient with clinical evidence of diabetic peripheral neuropathy to be at risk for foot ulceration, and provide education on foot care. [ 71 ] If necessary, refer the patient to a podiatrist. Admit patients for an infected diabetic foot ulcer or gangrene. For more information, see Diabetic Foot Infections . Patients with diabetic peripheral neuropathy require more frequent follow-up, with particular attention to foot inspection to reinforce the need for regular self-care. The provision of regular foot examinations and reinforcement of the educational message on foot care have been shown in several studies to significantly reduce rates of ulceration and even amputation. [ 72 ] The primary care physician is responsible for educating patients about the acute and chronic complications of diabetes, [ 46 ] including the psychological impact of sexual dysfunction in both men and women. The importance of involving a neurologist (preferably with expertise in peripheral neuropathy) in the treatment of patients with diabetic neuropathy cannot be overemphasized. Of all treatments, tight and stable glycemic control is probably the most important for slowing the progression of neuropathy. [ 73 ] Because rapid swings from hypoglycemia to hyperglycemia have been suggested to induce and aggra Continue reading >>

What Is Diabetic Neuropathy?

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 Neuropathy

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 >>

Diabetic Neuropathy

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 Foot Pain

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 >>

Diabetic Neuropathy Overview

Diabetic Neuropathy Overview

Diabetes can damage nerves throughout your body. In fact diabetic neuropathy (neuro- means nerves; -pathy means disease or suffering) is the most common, chronic complication of diabetes according to the American Diabetes Association.1 It affects 60-70% of people with type 1 and type 2 diabetes, according to the National Institute of Diabetes and Digestive and Kidney Disease. 2 Diabetic neuropathy can be extremely painful. It can also pave the way for health-threatening and even life-threatening problems including foot ulcers, amputations, heart attacks, digestion problems and difficulty recognizing low blood sugar episodes. While it cannot be cured, smart lifestyle steps may prevent diabetic neuropathy for some people and slow its progression for others. Medications and other approaches can treat symptoms, such as pain. And awareness—through steps like good foot care, regular foot exams and telling your doctor about other symptoms—can help prevent this blood-sugar-related nerve damage from spiraling into even more serious health issues. The best-known type of diabetic neuropathy is called diabetic peripheral neuropathy. It can cause burning, stabbing or electric-shock-type pain or tingling in your feet, legs, hands or arms. The pain may be worse at night; treatment options range from over-the-counter patches to prescription drugs. But there’s growing evidence that diabetes causes deeper nerve damage that affects more people with high blood sugar than experts once understood. Other types of diabetic neuropathy include: “Silent” diabetic peripheral neuropathy. Up to 50% of people with peripheral neuropathy have no pain3 and may not realize their feet are numb. 4 This boosts the risk for foot ulcers (if you don’t notice cuts or blisters, for example) 5 and inc Continue reading >>

Tips For Treating Diabetic Nerve Pain

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 >>

More in diabetes