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Can diabetes cause peripheral neuropathy?
When does diabetic peripheral neuropathy appear?
What are the treatment options for diabetic peripheral neuropathy?
Feb 25, 2024 · Peripheral neuropathy encompasses a broad range of clinical pathologies potentially presenting with peripheral nervous system dysfunction. Patients with peripheral neuropathy often present with varying degrees of numbness, tingling, aching, burning sensation, weakness of limbs, hyperalgesia, allodynia, and pain.
- Myron A. Bodman, Matthew Varacallo
- 2024/02/25
- 2017
Feb 10, 2023 · Peripheral neuropathy (PN) is one of the main microvascular complications of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM), more frequent than nephropathy and retinopathy, and is the leading cause of lower limb amputation in western countries [2, 3, 4].
- 10.3390/ijms24043554
- 2023/02
- Int J Mol Sci. 2023 Feb; 24(4): 3554.
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There are four main types of diabetic neuropathy. You can have one type or more than one type of neuropathy.
Your symptoms depend on the type you have and which nerves are affected. Usually, symptoms develop gradually. You may not notice anything is wrong until considerable nerve damage has occurred.
Call your health care provider for an appointment if you have:
•A cut or sore on your foot that is infected or won't heal
•Burning, tingling, weakness or pain in your hands or feet that interferes with daily activities or sleep
•Changes in digestion, urination or sexual function
•Dizziness and fainting
The American Diabetes Association (ADA) recommends that screening for diabetic neuropathy begin immediately after someone is diagnosed with type 2 diabetes or five years after diagnosis with type 1 diabetes. After that, screening is recommended once a year.
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The exact cause of each type of neuropathy is unknown. Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients.
Anyone who has diabetes can develop neuropathy. But these risk factors make nerve damage more likely:
•Poor blood sugar control. Uncontrolled blood sugar increases the risk of every diabetes complication, including nerve damage.
•Diabetes history. The risk of diabetic neuropathy increases the longer a person has diabetes, especially if blood sugar isn't well controlled.
•Kidney disease. Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nerve damage.
•Being overweight. Having a body mass index (BMI) of 25 or more may increase the risk of diabetic neuropathy.
•Smoking. Smoking narrows and hardens the arteries, reducing blood flow to the legs and feet. This makes it more difficult for wounds to heal and damages the peripheral nerves.
Diabetic neuropathy can cause a number of serious complications, including:
•Hypoglycemia unawareness. Blood sugar levels below 70 milligrams per deciliter (mg/dL) — 3.9 millimoles per liter (mmol/L) — usually cause shakiness, sweating and a fast heartbeat. But people who have autonomic neuropathy may not experience these warning signs.
•Loss of a toe, foot or leg. Nerve damage can cause a loss of feeling in the feet, so even minor cuts can turn into sores or ulcers without being noticed. In severe cases, an infection can spread to the bone or lead to tissue death. Removal (amputation) of a toe, foot or even part of the leg may be necessary.
•Urinary tract infections and urinary incontinence. If the nerves that control the bladder are damaged, the bladder may not empty completely when urinating. Bacteria can build up in the bladder and kidneys, causing urinary tract infections. Nerve damage can also affect the ability to feel the need to urinate or to control the muscles that release urine, leading to leakage (incontinence).
•Sharp drops in blood pressure. Damage to the nerves that control blood flow can affect the body's ability to adjust blood pressure. This can cause a sharp drop in pressure when standing after sitting or lying down, which may lead to lightheadedness and fainting.
•Digestive problems. If nerve damage occurs in the digestive tract, constipation or diarrhea, or both are possible. Diabetes-related nerve damage can lead to gastroparesis, a condition in which the stomach empties too slowly or not at all. This can cause bloating and indigestion.
Blood sugar management
The American Diabetes Association (ADA) recommends that people living with diabetes have a glycated hemoglobin (A1C) test at least twice a year. This test indicates your average blood sugar level for the past 2 to 3 months. glycated hemoglobin (A1C) goals may need to be individualized, but for many adults, the ADA recommends an A1C of less than 7.0%. If your blood sugar levels are higher than your goal, you may need changes in your daily management, such as adding or adjusting your medications or changing your diet or physical activity.
Foot care
Foot problems, including sores that don't heal, ulcers and even amputation, are common complications of diabetic neuropathy. But you can prevent many of these problems by having a thorough foot exam at least once a year. Also have your health care provider check your feet at each office visit and take good care of your feet at home. Follow your health care provider's recommendations for good foot care. To protect the health of your feet: Request an appointment By Mayo Clinic Staff Apr 29, 2022 1.Ferri FF. Diabetic polyneuropathy. In: Ferri's Clinical Advisor 2022. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 17, 2021. 2.Diabetic neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/all-content. Accessed Jan. 10, 2020. 3.American Diabetes Association. Standards of medical care in diabetes — 2021. Diabetes Care. 2021. https://care.diabetesjournals.org/content/44/Supplement_1. Accessed Nov. 11, 2021. 4.AskMayoExpert. Peripheral neuropathy (adult). Mayo Clinic; 2021. 5.Feldman EL, et al. Management of diabetic neuropathy. https://www.uptodate.com/contents/search. Accessed Dec. 17, 2021. 6.Diabetes and foot problems. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems#healthyfeet. Accessed Jan. 10, 2020. 7.Jankovic J, et al., eds. Disorders of peripheral nerves. In: Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Jan. 11, 2020. 8.Baute V, et al. Complementary and alternative medicine for painful peripheral neuropathy. Current Treatment Options in Neurology. 2019; doi:10.1007/s11940-019-0584-z. 9.Feldman EL, et al. Diabetic neuropathy. Nature Reviews — Disease Primers. 2019; doi:10.1038/s41572-019-0092-1. 10.Cutsforth-Gregory (expert opinion). Mayo Clinic. Dec. 24, 2021. 11.Castro MR (expert opinion). Mayo Clinic. Jan. 21, 2022. Diagnosis & treatment 1.Diseases & Conditions 2.Diabetic neuropathy symptoms & causes
•Diabetic neuropathy and dietary supplements
•Types of diabetic neuropathy
Diabetic neuropathy is a nerve damage that can occur in people with diabetes. Learn about the four types of neuropathy, including peripheral neuropathy that affects the legs and feet, and how to prevent or treat it.
Among various forms of neuropathy, diabetic peripheral neuropathy (DPN) is the most common and has the strongest evidence base regarding therapeutic approaches. This American Diabetes Association clinical compendium summarizes the latest information about screening for, diagnosing, and treating painful DPN in routine clinical practice.
Peripheral neuropathy is a type of nerve damage that affects the feet and legs of many people with diabetes. Learn how to prevent, diagnose, and treat this condition that can cause pain, numbness, and foot problems.
Mar 15, 2024 · Peripheral neuropathy is the most common type of diabetic neuropathy. It can affect nerves in the feet, legs, hands and arms. It often starts in the feet, usually affecting both feet at the same time. Most often, peripheral neuropathy symptoms affect both sides of the body. The symptoms can include:
Learn about the risk factors, screening, diagnosis, and management of diabetic peripheral neuropathy, a common complication of diabetes mellitus. Find evidence-based recommendations, clinical guidelines, and nondrug therapies for symptom relief and prevention.
