Diabetic Neuropathy: Understanding Nerve Damage in Diabetes

If you have diabetes and are experiencing pain, tingling or numbness in your legs and feet, and possibly your hands and arms, you likely are experiencing a nerve damage condition called diabetic neuropathy. What is diabetic neuropathy?

While diabetic neuropathy can have an adverse effect on your quality of life, there are steps you can take to manage it once you receive a diagnosis.

Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. It is a result of the chronically elevated blood sugar levels that come with this disease. Mayo Clinic reports that around half of people with diabetes develop diabetic neuropathy.

There are several different types of diabetic neuropathy. These include peripheral neuropathy, autonomic neuropathy and focal neuropathy.

The most common form of diabetic neuropathy is peripheral neuropathy, which is also referred to as distal symmetric peripheral neuropathy. It is a type of nerve damage that produces symptoms first in the feet and legs, and then often in the hands and arms as well. 

Some symptoms you may experience with peripheral neuropathy include burning, tingling, numbness, reduced temperature sensations, cramping, and heightened sensitivity. More serious problems, such as foot ulcers, may also develop.

Autonomic neuropathies can affect a wide range of organs that are regulated by the autonomic nervous system. People who are experiencing autonomic neuropathy may experience symptoms such as blood pressure drops, difficulty swallowing, vision problems, bladder problems, bowel problems, poor blood sugar awareness, unusual sweating, erectile dysfunction, or vaginal dryness.

Another word for this type of neuropathy is mononeuropathy. “Mono” here means “one.” Focal neuropathy affects just one nerve, most commonly in the arm, leg, torso or face.

Possible symptoms include pain, weakness, numbness, tingling, paralysis, or vision problems.

As we have discussed above, the symptoms for neuropathy depend on which type of diabetic neuropathy you have and its location. Neuropathy symptoms can be mild, moderate or severe. They can come and go, or they can be constant and intractable. Let’s discuss a few of the common symptoms in a little more detail.

For many people, numbness is one of the most problematic symptoms of diabetic neuropathy. Not only can numbness be unpleasant from a sensory standpoint, but it can make it hard to do some everyday tasks.

For example, if you have numbness in your feet, you may have a difficult time lifting your feet while you walk to maintain a natural gait. You might be prone to tripping and falling, or might not notice if you hurt your feet while you are walking.

Sometimes diabetic neuropathy affects the digestive system. When this happens, it can result in a few different digestive problems, such as constipation, diarrhea, or gastroparesis (slow stomach emptying). When the stomach empties slowly, you may experience symptoms such as indigestion and bloating.

When neuropathy affects muscles, such as those in your feet, you might experience cramping. The pain associated with cramps can be sharp and unpleasant. And as with numbness, it can sometimes be difficult to go about your daily tasks when you are experiencing cramps.

Let’s talk a bit more about what actually causes diabetic neuropathy.

Patients with high blood pressure and cholesterol can sometimes go on to develop insulin resistance and type-2 diabetes. Once diabetes develops, blood sugar may be chronically high, which can cause the nerve damage that results in diabetic neuropathy.

If you are eating an unhealthy diet, not exercising, and are overweight, those are all factors that can increase your chances of experiencing diabetic neuropathy. Smoking is another risk factor for this type of nerve damage. 

Luckily, those are all things you can do something about. Adopting a healthy diet and exercise routine, and not smoking can help.

Peripheral neuropathy can be caused by physically injuring the nerves as well. So, that is one more cause to keep in mind.

When you visit your doctor for a diagnosis, they will begin by giving you a basic physical exam and asking you questions to assess your symptoms and medical history.

Sometimes, additional testing may be necessary. Some types of diagnostic tests that can be used to identify diabetic neuropathy include filament testing, sensory testing, nerve conduction testing, electromyography and autonomic testing.

There is no way to cure diabetic neuropathy right now. But there are things you can do to help you manage your condition. After your diagnosis, your doctor will work with you to create a personalized treatment plan.

To start, you will need to treat the diabetes itself. Your doctor will help you establish a target blood sugar level.

While you are treating the diabetes, you may be given pain medications for the neuropathy symptoms. Most commonly, these may include antidepressants and anti-seizure drugs. 

If you have a type of neuropathy that is affecting organ function, you may be given medications to improve urinary function, digestive function, sexual function, and/or blood pressure, depending on your symptoms.

Your doctor will advise you to make some changes to your lifestyle, including eating a healthy diet rich in fruits, vegetables and whole grains, and maintaining a regular exercise routine. If you currently smoke, you will need to stop. 

Exercising when you have peripheral neuropathy may sound intimidating, since pain and numbness can interfere with your comfort and your gait. 

One solution is to shop for shoes designed for patients with neuropathy. Cadense Original Adaptive Shoes for men and women with patented variable friction technology make it easier to walk with neuropathy by helping the wearer “glide” across obstacles and uneven surfaces, even if they cannot completely lift their feet due to numbness and foot drop.

These shoes offer some additional advantages for people with diabetic neuropathy as well. They are comfortably cushioned, and fit snugly without restricting blood flow. Their lightweight materials reduce fatigue so you can exercise for longer without fatiguing.

When the right shoes are making walking safer and more enjoyable, it becomes easier to motivate yourself to keep exercising.

As you make workouts a regular part of your routine, you may start experiencing improvements in your health. The CDC explains that your insulin sensitivity increases when you live an active lifestyle. It can also help you maintain healthy blood sugar levels. 

As a result, you can help keep your diabetes in check. Your risk of future nerve damage decreases along with your risk of heart disease. 

If you do not yet have diabetes, but are pre-diabetic, exercising can help you reduce your risk of developing this disease.