Neuropathy

Nerves send messages to and from the brain. Nerves are named by what they do:

  • Sensory nerves send messages to your brain about what you feel (touching a hot stove).
  • Motor nerves send messages from the brain to a body part causing it to react (removing your hand from the hot stove).
  • Autonomic nerves control the things your body does naturally (digest food, heart rate, blood pressure, breathing).

What is neuropathy? Damage to nerve cells is called neuropathy. It is the most common problem with diabetes. It is unclear why this happens. When blood sugar levels remain high, nerve endings are damaged. Damaged nerves cannot send messages through the body as they should. Nerve damage can happen slowly. You may not even notice the earliest signs of nerve damage. Diabetes can affect all types of nerves.

What happens to the feet, legs and hands? Neuropathy can affect the feet, legs and hands. Symptoms depend on the type of nerves involved and the amount of damage. You could have numbness or tingling, pain and burning, decreased feeling and muscle weakness. It may come and go, and it may subside with lower blood sugar levels. If you are unable to feel heat or pain, you could easily injure yourself without knowing it. Decreased blood flow to the feet and legs presents another problem. Decreased blood flow could cause slow-healing wounds and lead to infection. Treatments for pain include medicines, walking (to decrease leg pain), relaxation exercises, hypnosis or biofeedback training, transcutaneous nerve stimulation (TENS) units and pain clinics.

What is autonomic neuropathy? One type of autonomic neuropathy occurs when there is damage to the nerves that control digestion. Damage to the stomach nerves is called gastroparesis which may cause delayed stomach emptying. If the stomach remains full, nausea, bloating and vomiting occurs. Damage to the intestinal nerves leads to slower movement of food through the intestines. This results in a build-up of bacteria. It could cause constipation and/or diarrhea.

Other signs of autonomic nerve damage include:

  • Loss of ability to sweat normally.
  • Feeling light-headed when standing up. This happens because of a drop in blood pressure.
  • You may also find it hard to tell when your blood sugar is low.
  • Leaking of urine or difficulty urinating.
  • Damage to the nerves that control sexual function. This can happen in both men and women. There are treatments for this.

There are things you can do to prevent or delay nerve damage:

  • Keep your blood sugar levels normal. Any improvement in your blood sugar control helps to prevent problems.
  • Reduce risk factors - smoking, obesity and high blood pressure.
  • Take care of your feet. Check your feet daily. Have your doctor check them at each visit. Exercise to improve blood flow to feet and hands.
  • Check with your doctor before starting an exercise program.
  • See your doctor at least 2-4 times a year. Report any symptoms you are having. Early treatment is best.
  • Read articles and go to support groups to learn as much as you can.

How can your doctor help you? There are many new treatments for neuropathy. These include medicines, changes in diet and tight control of your blood sugar. Ask your doctor what your blood sugar targets should be. Discuss any changes needed to improve your control. This will help decrease problems and maintain good health.

http://www.diabetes.org/living-with-diabetes/complications/neuropathy/ Accessed 6/17/19