Diabetic neuropathy is nerve damage that occurs as a complication of diabetes. This nerve damage is caused by blood glucose levels that remain too high for long periods of time.
Research into why diabetic neuropathy occurs is ongoing. Excess glucose in the bloodstream causes damage to blood vessels, including the small blood vessels that supply nerves with oxygen and nutrients. This can disrupt the delivery of oxygen and nutrients to the nerves. As a result, nerves may not function normally, and nerves may die. Elevated blood glucose levels may also trigger the release of inflammatory chemicals, which can contribute to nerve damage.
Here, we take a closer look at what happens when a person has diabetic neuropathy and treatment for diabetic neuropathy.
Types of diabetic neuropathy
There are multiple types of diabetic neuropathy. Different types affect different parts of the nervous system, and the symptoms and complications that occur will depend on the part of the nervous system that is impacted.
Peripheral neuropathy is the most common type. It usually affects the feet and legs, but can also affect the hands and arms. Symptoms can include numbness, tingling, and shooting or burning pains. Complications can include foot ulcers (wounds that won’t heal), infections, and a risk of amputations.
Other types of diabetic neuropathy can include:
- Damage to the nerves that control internal organs. Called autonomic neuropathy, this can cause problems with digestion, bowel and bladder control, sexual dysfunction, heart rate and rhythm, blood pressure, and vision. It can also interfere with a person’s ability to feel symptoms associated with hypoglycemia (dangerously low blood glucose levels).
- Damage to single nerves, such as a nerve in a hand, leg, or the face. This is called focal neuropathy and is less common. Pain, tingling, numbness, and weakness are common symptoms.
- Damage to a nerve in the hip, buttock, or thigh, called proximal neuropathy. This type is rare, but it can cause severe pain and is often disabling.
Treatment for diabetic neuropathy
There is no cure for diabetic neuropathy, and treatment focuses on preventing nerve damage from getting worse, controlling symptoms, and preventing complications.
Diabetes control
Improving diabetes control will include changing how you manage blood glucose levels as well as other factors that can damage the blood vessels and nerves, such as cholesterol levels and blood pressure. Elevated numbers will continue to damage the nervous system, causing symptoms and complications to become worse.
Steps to improving diabetes control can include changes to diet, changes to diabetes medications, weight loss, and additional lifestyle changes. A healthcare provider will be your best source of information about the steps you need to take.
Managing pain
Pain is one of the most common symptoms of peripheral diabetic neuropathy. Diabetic nerve pain is described as burning, shooting, and/or extreme sensitivity to touch. Tingling and numbness are also common. These symptoms can significantly impact a person’s quality of life and interfere with sleep.
If you are experiencing diabetic nerve pain, pain management will be a focus of treatment. Therapies for diabetic nerve pain include certain types of antidepressants and antiseizure medications. These medications act on the nervous system and block pain.
Topical therapies that are applied to the skin that contain capsaicin can also be used to treat diabetic nerve pain. Capsaicin is found in plants like cayenne peppers, and medicines that contain capsaicin are also effective in treating arthritis pain and pain from injuries (and are also being studied in the treatment of pain related to cancer and cancer treatments).
Other treatment options include local anesthetics, physical therapy, and transcutaneous electrical nerve stimulation (TENS).
Foot checks and foot care
Injuries and problems with the feet are a common complication of diabetic neuropathy and will be a focus of treatment. People with diabetes should talk to a healthcare provider about caring for the feet, proper footwear, and the importance of daily checks for wounds and ulcers.
Treatment for other complications
A treatment plan should also address other complications of diabetic neuropathy that a person is experiencing, such as problems with bladder control, sexual function, or changes to mobility and function.
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