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Diabetic Neuropathy


What is diabetic neuropathy?

Diabetic neuropathy (DN) is a condition caused by nerve damage from long-term high blood sugar levels. The most common nerve damage occurs in the legs, feet, arms, or hands. Nerves in your heart or digestive system may also be damaged.

What increases my risk for DN?

  • Poor blood sugar control
  • Having diabetes for more than 10 years
  • High blood pressure, high cholesterol, or lack of vitamin D

What are the signs and symptoms of DN?

  • Muscle weakness or problems balancing or walking
  • Pain, cramping, numbness, or little or no movement of your hands, arms, legs, or feet
  • Problems exercising, or feeling more tired than usual
  • Trouble swallowing, nausea, vomiting, diarrhea, or constipation
  • Feeling full after you eat a small amount of food, or fluctuations in your blood sugar levels
  • Itchy or dry skin, hair loss on your arms or legs, or calluses
  • Loss of bladder control, loss of bowel movement control, impotence, vaginal dryness, or decreased sexual desire
  • Fast resting heart rate, or dizziness

How is DN diagnosed?

Your healthcare provider will check how well you can feel certain sensations such as touch or temperature. He will also check your reflexes, strength, and flexibility. You may need any of the following tests:

  • Blood tests may show your A1c and electrolyte levels, or thyroid function.
  • An electromyography (EMG) test measures the electrical activity of your muscles at rest and with movement.
  • Nerve conduction studies show how surface nerves and related muscles in the body respond to stimulation.
  • A gastric-emptying scan measures how quickly food moves out of your stomach. A slightly radioactive substance is placed in food. The amount of radiation is small and safe. You eat the food and then lie under a machine that takes pictures of the food inside your stomach. Pictures will be taken every 15 minutes, up to 4 hours after you eat, or as directed.
  • An EKG or other heart tests record your heart rhythm and how fast your heart beats. It is used to check for heart problems caused by DN.
  • Urine tests may show bladder control, function, and other problems caused by DN.

How is DN treated?

The goal of treatment is to prevent more nerve damage. You may need these or other medicines:

  • Insulin or diabetes medicine may be given to decrease the amount of sugar in your blood.
  • Nausea medicine helps calm your stomach and prevent vomiting.
  • Motility medicine helps your stomach muscles move food and liquids out of your stomach faster. This medicine also may help you digest food better.
  • Prescription pain medicine may be given. Ask how to take this medicine safely.

How can I manage my symptoms?

  • Control your blood sugar. Keep your blood sugar levels as close to normal as possible. You may need to check your blood sugar levels 3 times each day.

  • Follow the meal plan that your healthcare or dietitian gave you. This meal plan can help you control your blood sugar and decrease your symptoms.
  • Care for your feet. Check your feet each day for cuts, scratches, calluses, or other wounds. Look for redness, swelling, and warmth. Wear shoes that fit well. Check your shoes for rocks or other objects that can hurt your feet. Do not walk barefoot or wear shoes without socks. Wear cotton socks to help keep your feet dry.
  • Exercise regularly. Exercise can help keep your blood sugar level steady and help you manage your weight. Exercise for at least 30 minutes, 5 days a week. Ask your healthcare provider about the best exercise plan for you. Use caution when you exercise if you have decreased feeling in your feet.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. A healthy weight can help you control your diabetes. Ask him to help you create a weight loss plan if you are overweight. Even a 10 to 15 pound weight loss can help you manage your blood sugar level.
  • Limit alcohol. Alcohol affects your blood sugar level and can make it harder to manage your diabetes. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Do not smoke. Nicotine can worsen your symptoms and make it more difficult to manage your diabetes. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.

Call 911 for any of the following:

  • You have pain, pressure, or fullness in your chest that lasts longer than a few minutes or returns.
  • You have pain or discomfort in your back, neck, jaw, stomach, or arm.
  • You have a sudden cold sweat.

When should I seek immediate care?

  • Your legs or feet start to turn blue or black.
  • You have a wound that does not heal or is red, swollen, or draining fluid.

When should I contact my healthcare provider?

  • You have nausea or are vomiting.
  • Your blood sugar level is higher or lower than healthcare providers have told you it should be.
  • You have redness, calluses, or sores on your feet.
  • You have diarrhea or are constipated.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.