Diabetic Neuropathy
GENERAL INFORMATION:
What is diabetic neuropathy? Diabetic (deye-ah-BET-ik) neuropathy is a disease of the nervous system caused by having diabetes for a long time. The nervous system includes the brain, spine, and nerves in the body. Diabetes is a condition where your body makes little or no insulin, causing high blood sugar levels. With diabetic neuropathy, the nerves carrying information to and from the brain or spine are affected. Diabetic neuropathy may affect what or how you feel in your hands, arms, legs, or feet. It may also affect other body organs, such as the heart, digestive organs, or sexual organs.
What causes diabetic neuropathy? High blood sugar levels may damage the nerves and blood vessels carrying oxygen and nutrients to the nerves. Having long term uncontrolled type 1 or type 2 diabetes is the main cause of diabetic neuropathy. The longer you have diabetes, the more likely you will have nerve problems. The following conditions may increase your chances of diabetic neuropathy becoming worse:
- Diabetic retinopathy (eye problems caused by diabetes).
- Diabetic nephropathy (kidney problems caused by diabetes).
- Heart problems.
- Hypertension (high blood pressure).
What are the signs and symptoms of diabetic neuropathy? The signs and symptoms of neuropathy depend on which nerves are affected. You may have any of the following signs or symptoms:
- Difficulty swallowing, nausea (upset stomach), vomiting (throwing up), diarrhea (loose bowel movements), or constipation (hard, dry bowel movements that are difficult to pass).
- Itchy or dry skin, hair loss in your arms or legs, or increased calluses.
- Loss of bladder control (urinary incontinence), impotence (problems with erections in males), vaginal dryness in females, or decreased sexual desire.
- Muscle weakness or problems in balancing or walking.
- Pain, numbness, paralysis (inability to move), or cramping of your hands, arms, legs, or feet.
- Problems exercising, fatigue (feeling tired more than usual), or frequent dizziness.
How is diabetic neuropathy diagnosed? Diabetic neuropathy may be diagnosed based on your symptoms and physical exam. Your sensitivity (awareness) to position, vibration, pinprick, or a light touch will be checked. The reflexes, strength, and flexibility of your toes, foot, and ankle will also be tested. Inability to feel light touch on the soles of the feet and decreased reflexes may indicate neuropathy. Your feet will also be checked for any signs of ulcers. These may include calluses, bunions, or tender areas. You may also have the following tests:
- 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
- Electromyography (EMG): Electromyography is a test that measures the electrical activity of your muscles. Your muscles are tested at rest and while you are using them. An EMG test may also check the nerves that control your muscles.
- Nerve conduction studies: This is a group of tests that are done to check how surface nerves and related muscles in the body respond to stimulation. Electrodes with wires or tiny needles are placed on certain areas of the body for these tests.
- Radioisotope gastric-emptying scan: A special x-ray machine uses a special camera to take pictures of your stomach. You are given food to eat that has a small, safe amount of radioactive material in it before taking the pictures. Caregivers then watch the pictures to see how quickly the food leaves your stomach. People who are allergic to shellfish (crab, lobster, or shrimp) may be allergic to the material. Tell your caregiver if you are allergic to any of these foods.
- Urine tests: A sample of your urine is collected and sent to a lab for tests. A flow rate recording may be done to measure the speed of your urine stream. Caregivers may then use a catheter to measure how much urine is left in your bladder after you finish urinating.
How is diabetic neuropathy treated? The main treatment of diabetic neuropathy is to keep the nerves from being damaged further. This can be done by having blood sugar levels within the normal range. Eating the right foods, exercising, taking your medicines, and controlling your weight are very important in controlling diabetes. Medicines to ease pain may be given for diabetic neuropathy.
Where do I find support and more information? Having diabetic neuropathy may be life-changing for you and your family. Accepting that you have diabetic neuropathy may be hard. You may want to join a support group which is a group of people who also have diabetes. Contact the following for more information:
- American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1-800-342-2383
Web Address: http://www.diabetes.org
- National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Phone: 1-800-860-8747
Web Address: www.diabetes.niddk.nih.gov/
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Building 31, room 9A04 Center Drive, MSC 2560
Bethesda, MD 208922560
Web Address: http://www.niddk.nih.gov
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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