What is diabetic neuropathy?

When you have diabetes, your blood sugar level may get too high. Over time, high blood sugar levels can damage nerves. This is called diabetic neuropathy.

Nerve damage can cause pain, burning, tingling, and numbness. It may leave you feeling weak. The feet are often affected. When you have nerve damage in your feet, you cannot feel your feet and toes as well as normal. You may not notice cuts or sores. Even a small injury can lead to a serious infection. It's important that you follow your doctor's advice on foot care.

Sometimes diabetes damages nerves that help the body function. If this happens, your blood pressure, sweating, digestion, and urination might be affected. Your doctor may give you a target range for your blood sugar that is higher or lower than you are used to. Try to keep your blood sugar very close to this target range to prevent more damage.

Symptoms depend on which nerves are injured. You may have burning or shooting pain in your arms and legs. Or you may not be able to feel pain, especially in your feet. This can lead to serious infections if sores aren't treated. Other symptoms may include problems with digestion, urination, and blood vessels.

Treatment involves keeping blood sugar levels in your target range. This will not cure the nerve damage, but it can help keep the damage from getting worse, and the pain might get better. Other treatments, such as medicines for pain or digestive problems, depend on your symptoms.

During a physical exam, your doctor may check how well you can feel light touch, temperature, pain, vibration, and movement. Your doctor may also check your strength and reflexes. Tests such as an electromyogram and nerve conduction studies may be done to confirm the diagnosis. You may need other tests to see which type of neuropathy you have and to help guide your treatment.

Doctors can't test for all types of nerve damage. So it's important to tell your doctor about any pain or weakness you feel. Also mention heavy sweating or dizziness and any changes in digestion, urination, and sexual function.

Take medicines as prescribed and try to keep your blood sugar in your target range. Take and record your blood pressure at home if your doctor tells you to. Avoid smoking and limit alcohol. Take care of your feet and check them daily. Tell your doctor right away if you have a foot sore.

Regular exercise may help manage your diabetes, which can reduce your risk of severe diabetic neuropathy. If you have nerve damage, you may need to avoid certain exercises to stay safe.

Talk to your doctor before you start an exercise program. Autonomic neuropathy may increase your risk of having heart, blood pressure, or body temperature problems during exercise. Your doctor can help you plan an exercise program that is safe and works for you.

Have your doctor check your legs and feet for signs of peripheral neuropathy. If you have nerve damage in your feet, avoid repetitive, weight-bearing exercises, such as long walks or runs. This type of exercise can cause ulcers, fractures, and joint problems. Make sure you have properly fitted shoes to protect your feet from injury. Try to choose exercises that don't put stress on your feet, such as:

• Swimming.
• Bicycling.
• Rowing.
• Seated exercises.
• Arm and upper-body exercises.
• Other non-weight-bearing exercises.

Diabetic neuropathy is nerve damage caused by diabetes. Over time, high blood sugar levels can damage nerves throughout your body.

There are several types.

• Peripheral neuropathy. This is damage to peripheral nerves. They sense pain, touch, hot, and cold. They also affect movement and muscle strength. The nerves in the feet and lower legs are most often affected. The damage can get worse with time.
• Autonomic neuropathy. This is damage to autonomic nerves. They control things like your heartbeat and blood pressure. They also control digestion, urination, and sexual function.
• Atypical neuropathies. One type affects just one nerve. It's called mononeuropathy. It often affects a nerve in the wrist or foot. It can also affect a nerve that controls eye muscles. Another type affects many nerves. It's called polyradiculoneuropathy. It often affects nerves in the back and chest. These types of nerve damage happen all of a sudden. They can get better with time.

Over time, high blood sugar levels from diabetes can damage nerves throughout your body. The higher your blood sugar levels, the more likely you are to have nerve damage.

Also, the older you get and the longer you have diabetes, the more likely you are to have nerve damage. Having high blood pressure and high cholesterol can also increase your risk of having diabetic neuropathy.

If you have diabetic neuropathy, you need to break in new shoes slowly. This is especially important with leather shoes.

• The first week, wear your new shoes only 1 to 2 hours a day.
• The second week, wear your new shoes 2 to 3 hours a day.
• You can increase the amount of time you wear the new shoes each week.

When you wear new shoes, check your feet for pressure spots, redness, or blisters twice a day.