Diabetes and Nerve Damage

If you’re among the more than 34 million Americans living with diabetes, managing your disease is one of the most important responsibilities you have each day. Not only is it the key to feeling your best and being there for your family and friends, it’s also important in the prevention of serious diabetes-related complications, including heart disease, kidney disease, vision problems, and nerve damage.

In this post, we’ll discuss diabetic neuropathy (nerve damage) and the different ways it can manifest in your body. The symptoms of nerve damage usually develop extremely slowly, so by the time someone with diabetes notices any significant signs, it’s likely that the problem has been progressing for quite some time, and, in fact, that person may already be facing considerable nerve damage. 

Depending on the type of neuropathy being experienced, diabetic nerve damage can lead to a number of different symptoms, including numbness or pain in the legs and feet, digestive disorders, urinary issues, and sensitivity to touch. In some people, the symptoms are relatively mind, such as tingling in the hands and feet. In others, diabetic neuropathy can have debilitating consequences with severe pain that makes it hard to get around comfortably.

What causes diabetes-related nerve damage?

According to the Mayo Clinic, diabetic neuropathy is a serious condition that may, in some form or another, affect as many as half of all individuals living with diabetes. What’s the primary cause? Take one good guess.

Yep, it’s elevated blood sugar. When someone with diabetes consistently finds their blood sugar tests come up high, and these elevations persist over an extended period of time it dramatically increases the risk of diabetic neuropathy.

Can you prevent diabetic neuropathy?

The best way to slow or possibly prevent the onset of nerve damage is to maintain consistent control over your blood glucose levels. This means sticking to those healthy lifestyle decisions. Watch what you eat. Squeeze enough physical activity into your schedule. Do what you can to reduce stress and anxiety levels.

More than anything else, controlling blood sugar means adhering to your doctor-approved diabetes testing and treatment program. Test your blood sugar according to your regular schedule using a glucose meter and test strips or a continuous glucose monitoring (CGM) system. Plus, be sure to take insulin and other medication as directed, whether that’s by insulin syringe, pen needle or using a properly functioning insulin pump and infusion sets. 

If your blood sugar tests high, take the appropriate steps to lower it as recommended by your doctor. If your blood sugar is consistently elevated, see your doctor as you may need to make important adjustments to your diabetes treatment and medication plan.

Additionally, The American Diabetes Association (ADA) recommends getting an A1C test from your doctor at least twice a year. This simple blood test measures your average blood sugar over a 2–3-month period and is an effective way to spot any prolonged elevations in blood glucose.

The Four Types of Diabetic Neuropathy

There are four primary type of diabetes-related nerve damage. However, it’s quite possible for someone to experience symptoms from more than one form of neuropathy. Symptoms will depend on what type of nerve damage you have and how long you’ve been experiencing neuropathy (whether evident to you or not).

Peripheral Neuropathy

This is the most common form of diabetic nerve damage and is identified by tingling, numbness, burning, or pain in the extremities, usually beginning in the  feet and legs before moving to the hands and arms. Signs of peripheral neuropathy include:

• Numbness or a decreased ability to feel pain or sense hot and cold temperature changes.
• Tingling or burning sensation
• Cramping or stabbing pain
• Severe pain at the slightest touch. Even clothing rubbing against the body may cause extreme discomfort.
• Severe issues with the feet, including sores and ulcers that will not heal.

Autonomic Neuropathy

This form of neuropathy impacts the autonomic nerves, those that control the intestinal tract, digestive system, urinary functions, sweat glands, genitals, and other organs. Autonomic neuropathy can lead to serious conditions, including “paralysis of the bladder” in which the nerves of the bladder no longer respond to normal pressure as the bladder fills. This inhibits urination, causing a gradual buildup of urine in the bladder, which usually results in urinary tract infections.

Additionally, autonomic neuropathy can affect the sex organs, often causing erectile dysfunction in men and vaginal dryness in women. It can also damage the nerves of the small intestine, leading to either constipation or diarrhea.

Warning signs of autonomic neuropathy include:

• Nausea or vomiting after eating
• Bloating after eating
• Diarrhea or constipation
• Unpredictable blood sugar when tested after eating (high or low)
• Losing the “need to urinate” sensation
• Bladder infections
• Erectile dysfunction in men despite the desire for sex
• Issues with feeling “aroused” in women during sex
• Feeling faint or fainting suddenly for no reason
• Dizziness when standing up too quickly
• Unusual sweating
• Racing heartbeat even while at rest

Proximal Neuropathy

This form of neuropathy affects the nerves in the thigh, hips, buttocks, or legs. It usually manifests on one side of the body, but if not addressed can spread to the other side, as well. Symptoms include:

• Extreme pain in the hip, thigh, or buttock
• Weak thigh muscle that seem to shrink over time
• Difficulty standing after being seated for an extended period
• Severe stomach pain

Focal Neuropathy

Focal neuropathy is a rare condition in which a single nerve is damaged. This usually occurs in the hands, wrist, thigh, foot, or among the nerves that control the eye muscles. Symptoms include:

• Pain in a limited area of the foot, wrist, or thigh
• Aching pain behind one of the eyes
• Double vision in one of the eyes
• Bell’s Palsy (paralysis on one side of the face)
• Weakness in one hand that may cause you to drop items
• Numbness in one hand or set of fingers

Diabetic Neuropathy Risk Factors

While anyone who has Type 1 or Type 2 diabetes can develop diabetic neuropathy, there are factors that elevate your risk, including:

• Out-of-control blood sugar. We’ve already talked about this one. The basic cause of all diabetes-related nerve damage is blood sugar that is continuously high.

• How long you’ve had diabetes. The longer you’ve been living with diabetes, the greater the risk of nerve damage, especially if your blood sugar has been elevated during much of your history.

• Being overweight. Carrying too much weight contributes to elevated blood sugar levels and, therefore, adds to the risk of neuropathy

• Smoking. When you smoke, it narrows and hardens your arteries, reducing blood flow to the extremities. This can exacerbate damage to the peripheral nerves, particularly in the legs and feet - two major areas of concern for those suffering from diabetic neuropathy.

Should I call my doctor?

The symptoms of diabetic neuropathy can be vague, which is why people often hesitate to contact their diabetes physician. However, if you experience any of the symptoms related to any form of diabetes-related nerve damage, contact your doctor right away. Early treatment can prevent or delay further damage and help you avoid more serious complications.

As an early intervention and preventative measure, the American Diabetes Association (ADA), recommends that anyone diagnosed with Type 2 diabetes undergo an immediate neuropathy screening, and then continue to get screened annually. For those with Type 1 diabetes, the ADA recommends getting a neuropathy screening within the first five years of diagnosis, followed by annual screenings.