Medically Reviewed by: Scientific Advisory Board

Diabetic neuropathy is a common and concerning complication of diabetes that affects millions of people worldwide. It's a type of nerve damage that can occur in individuals with either type 1 or type 2 diabetes. High blood sugar levels can cause damage to nerve fibers throughout the body, leading to various symptoms and complications. By understanding what this condition entails, we can be better equipped to manage and potentially prevent its onset.

Although diabetic neuropathy can affect any nerve in the body, it most commonly impacts the nerves in the legs and feet. Symptoms can include numbness, tingling, pain, and weakness in the affected areas. In severe cases, individuals may lose sensation in their feet and develop sores, ulcers, or infections, which can ultimately lead to amputation. It's crucial to monitor and manage blood sugar levels closely, as well as maintain a healthy lifestyle to minimize the risk of this often-debilitating condition.

There are several types of diabetic neuropathy, including peripheral neuropathy, autonomic neuropathy, radiculoplexus neuropathy, and mononeuropathy. Each type affects different nerves and can present varying symptoms, ranging from mild to severe. Early diagnosis and treatment are crucial in managing the progression of diabetic neuropathy and preventing further complications. As we explore the various aspects of diabetic neuropathy, we aim to provide a comprehensive understanding of this condition and its implications on those living with diabetes.

Understanding Diabetic Neuropathy

Diabetic neuropathy is a condition affecting people with diabetes. It's a type of nerve damage that can occur if you have Type 1 or Type 2 diabetes. High blood sugar levels harm nerves throughout the body, though diabetic neuropathy most often affects nerves in the legs and feet.

There are several types of diabetic neuropathy, including:

• Peripheral Neuropathy: The most common form, causing pain or numbness in the hands, feet, or legs.
• Autonomic Neuropathy: Affecting nerves that control internal organs, potentially impacting digestion, bladder function, and more.
• Focal Neuropathy: Involving sudden and severe pain, usually in one nerve or group of nerves.
• Proximal Neuropathy: Typically causing pain in the hips, thighs, or buttocks, and affecting one side of the body.

The causes of diabetic neuropathy can vary. Prolonged high blood sugar damages nerves and interferes with their ability to transmit signals. Additionally, reduced blood flow and high levels of blood fats can weaken nerve fibers, making it harder for nerves to function.

The risk factors for developing diabetic neuropathy include:

• Duration of diabetes: Longer duration increases the likelihood of nerve damage.
• Poor blood sugar control: Consistently high blood sugar levels exacerbate nerve damage.
• Kidney disease: Diabetes can lead to kidney damage, affecting nerve function.
• Smoking and alcohol abuse: Both can impair blood flow and contribute to neuropathy.
• Obesity: A body mass index (BMI) greater than 24 increases the risk of neuropathy.

The symptoms of diabetic neuropathy can range from mild to debilitating, depending on the type and severity. Peripheral neuropathy often causes tingling, numbness, or pain in hands, feet, or legs. Autonomic neuropathy may lead to digestive issues, difficulty urinating, or even heat intolerance. Focal neuropathy can bring sudden pain in the face, chest, or limbs, while proximal neuropathy targets pain in the hips, thighs, or buttocks.

To minimize the risk of developing diabetic neuropathy, it's essential to manage diabetes effectively. This involves:

• Regular monitoring of blood sugar levels
• Following a well-balanced diet
• Engaging in regular exercise
• Quitting smoking and limiting alcohol intake.

It's crucial for people with diabetes to visit their healthcare providers frequently and report any changes in their symptoms. Early detection and management of diabetic neuropathy increase the chances of slowing its progression and preventing complications that can drastically impact a person's quality of life. 

Types and Symptoms

Diabetic neuropathy has various forms, and the symptoms vary depending on the type. It's crucial to recognize these differences, as it can help in early diagnosis and improve the management of diabetic complications.

Proximal neuropathy – also known as diabetic amyotrophy – primarily affects the hip, thigh, or buttock muscles. Here are the common symptoms:

• Muscle weakness, pain
• Abdominal swelling (in some cases)
• Weight loss

While pain can be severe, it often improves with time and proper treatment.

Peripheral neuropathy is the most common type and affects the nerves in the feet, legs, hands, or arms. Watch for these symptoms:

• Numbness, tingling, burning sensation
• Increased sensitivity to touch
• Decreased sensation or inability to feel temperature changes
• Sharp, stabbing pain

People with diabetes should routinely inspect their feet for signs of peripheral neuropathy and wear comfortable, supportive footwear.

Autonomic neuropathy targets the nerves controlling involuntary body functions, such as digestion, blood pressure, and sexual function. Common symptoms include:

• Nausea, vomiting, or bloating after meals
• Diarrhea or constipation
• Erectile dysfunction in men, vaginal dryness in women
• Dizziness, lightheadedness, or fainting due to drops in blood pressure
• Difficulty recognizing low blood sugar symptoms

Lastly, focal neuropathy causes sudden weakness or pain in specific nerves. The symptoms vary depending on the affected nerves:

• Severe pain in the lower back or pelvis
• Chest, abdominal, or eye pain
• Double vision or difficulty focusing

It's essential to address any unusual symptoms immediately, as early intervention can prevent further complications.

Common Causes

Diabetic neuropathy can develop as a result of uncontrolled blood sugar levels, which can damage nerve fibers throughout the body. Several factors contribute to the development of this condition, and it's important to be aware of these causes, as managing them may help prevent or slow the progression of diabetic neuropathy.

One primary factor is prolonged elevated blood sugar levels. When blood sugar remains too high for too long, it can damage the nerves and impair their ability to transmit signals. This is particularly harmful to nerves in the feet and legs, which is why diabetic neuropathy is often experienced there first.

Another contributor is age. As we age, our nerves become more susceptible to damage, particularly if we've had diabetes for a long time. The longer we live with diabetes, the greater the risk of developing neuropathy.

The type of diabetes also influences the onset of neuropathy. Those with Type 2 diabetes are more likely to develop nerve damage, as they typically have the condition for a longer period before diagnosis.

Additional factors that can contribute to the development of diabetic neuropathy include:

• High blood pressure -- consistently high blood pressure can harm blood vessels and nerves.
• Smoking -- tobacco use decreases blood circulation, leading to potential nerve damage.
• Nerve inflammation -- inflammation can cause direct damage to nerves or hinder their ability to function.
• Inherited genetic factors -- certain genes may predispose individuals to neuropathy.

To help prevent diabetic neuropathy, it's essential to manage these contributing factors. Some steps to take include:

• Maintaining healthy blood sugar levels by following a balanced diet, exercising regularly, and taking prescribed medications as directed.
• Controlling blood pressure through lifestyle changes, and if needed, medications.
• Quitting smoking to improve circulation and overall health.

It's important to note that while managing these factors might not guarantee prevention of neuropathy, it can significantly reduce the risk and slow its progression. By staying proactive in addressing these common causes, you can work towards maintaining better health and reducing the impact of diabetic neuropathy on your life.

Effective Treatment Options

Diabetic neuropathy requires proper management to alleviate symptoms and prevent complications. It's important to recognize that treatment may vary for different individuals. We've compiled a list of effective treatment options for individuals with diabetic neuropathy.

Blood sugar control is paramount when it comes to diabetic neuropathy management. Consistently maintaining blood sugar levels within the target range can slow the progression of the condition and improve nerve function.

• Medication adjustments: If you're already on medication for blood sugar control, consult your doctor to assess whether your current treatment plan is effectively controlling your blood sugar levels.
• Diet and exercise: Incorporating a well-balanced diet and engaging in regular physical activity are essential for managing blood sugar.

Medications can be prescribed to help alleviate pain and discomfort. There are several options available, and your healthcare provider will help determine which is most appropriate for your situation. Some common medication types include:

• Antidepressants
• Anticonvulsants
• Pain relievers
• Topical treatments, such as creams and patches

Lifestyle modifications can also help manage symptoms and enhance overall well-being. Here are some suggestions:

• Quit smoking: Smoking can worsen diabetic neuropathy as it constricts blood vessels, further reducing blood flow to nerves.
• Limit alcohol consumption: Excessive alcohol intake can exacerbate nerve damage.
• Foot care: Regularly inspect your feet for sores, ulcers, or infection. Proper footwear and quality diabetic socks, provide added support and protection.

Some individuals may benefit from alternative therapies. These treatments can complement traditional options and should be discussed with your healthcare provider before starting. Some examples include:

• Acupuncture
• Biofeedback
• Massage therapy
• Transcutaneous electrical nerve stimulation (TENS)

Implementing these treatment options can have a significant impact on managing diabetic neuropathy symptoms and promoting a higher quality of life. As with any medical condition, it's crucial to adhere to the advice and guidance of your healthcare provider. They'll help you develop the best course of action for your unique situation, ensuring optimal management of your diabetic neuropathy.

Prevention and Self-Care

We understand the challenges faced by people with diabetes and the importance of prevention and self-care in managing diabetic neuropathy. It's crucial to focus on key aspects like maintaining healthy blood sugar levels and taking care of your feet.

Achieving proper blood sugar control can help prevent the development of diabetic neuropathy. Here's a breakdown of recommended targets for blood sugar levels:

Time of Check	Blood Sugar Level
Before meals	80-130 mg/dL
1-2 hours after the start of a meal	<180 mg/dL

To maintain healthy blood sugar levels, consider these strategies:

• Always take your medication as prescribed
• Keep a balanced diet and incorporate regular exercise
• Regularly monitor your blood glucose levels
• Consult with your healthcare team about adjusting insulin doses

Taking care of your feet is another crucial aspect of preventing foot-related complications in diabetic neuropathy. We recommend the following ways to protect and care for your feet:

• Inspect your feet daily for cuts, blisters, or signs of infection
• Keep your feet clean and dry, especially between your toes
• Moisturize your feet to prevent dryness and cracking, but avoid applying lotion between your toes
• Trim your toenails carefully to avoid ingrown toenails
• Wear well-fitted shoes and diabetic socks
• Avoid walking barefoot and ensure your feet are protected

Additionally, healthy lifestyle habits can contribute to overall health and wellbeing:

• Get adequate sleep and manage stress levels
• Avoid smoking and limit alcohol intake
• Seek guidance from healthcare professionals for optimal mental health support

Remember, consistency in self-care plays a significant role in managing diabetic neuropathy. By making the right choices and working closely with your healthcare team, you can take control and live a healthy life with diabetes.

Conclusion

We've covered a lot in our discussion of diabetic neuropathy. From its causes and symptoms to the various treatment options and prevention strategies, we hope this article has provided valuable insights for those living with diabetes. Let's recap the key points:

• Diabetic neuropathy is a common complication of diabetes, affecting up to 50% of people with the condition
• High blood sugar levels can damage nerve fibers, leading to various forms of neuropathy, such as peripheral, autonomic, proximal, and focal neuropathies
• Symptoms may include numbness, tingling, pain, muscle weakness, and problems with digestion or blood pressure regulation
• Early detection is crucial for managing the condition, so it's important to regularly check for symptoms and consult with healthcare professionals

To manage diabetic neuropathy, several approaches can be taken:

• Maintaining healthy blood sugar levels through diet, exercise, and medication as prescribed by a healthcare provider
• Monitoring for signs of neuropathy and seeking prompt medical care if symptoms are detected
• Taking care of your feet by keeping them clean, dry, and protected, and wearing diabetic socks and proper foot ware.

Living with diabetic neuropathy can be a challenge, but with the right information and support, we can manage the condition effectively together. Remember that awareness, proper self-care, and communication with healthcare professionals are the keys to successfully navigating life with diabetic neuropathy. Stay positive and proactive about your health, and don't hesitate to reach out to resources for help with managing this condition.

References, Studies and Sources: 

NIH: Diabetic Neuropathy

Mayo Clinic - Diabetic neuropathy

More About Circufiber.com and Healthcare disclaimer:

Always consult your physician before beginning any program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. If you experience any pain or difficulty, stop and consult your healthcare provider. Circufiber.com socks are clinically proven to improve micro-circulation in feet and lower extremities in people with Diabetes. 

More Author Information:

Dr. Capozzi is a board-certified foot surgeon through the American Board of Foot and Ankle Surgery. He is a Diplomate of the American Academy of Wound Management and Fellow of the American College of Foot and Ankle Surgeons. He completed a three-year residency program in Foot and Ankle Reconstructive Surgery at St. Francis Hospital & Medical Center in Hartford, CT in 2010. Dr. Capozzi is a board-certified Wound Specialist® granted by the American Academy of Wound Management. He is also board-certified in Foot Surgery through the American Board of Foot and Ankle Surgery.