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Diabetic neuropathy

Neuropathy is damage to your nerves. Diabetic neuropathy damages the nerves that travel between your spinal cord and your muscles, skin, and other parts of your body.

These changes can be very gradual and you may not notice them. This is why it's essential you receive a foot screening and assessment from a podiatrist every year. You can then agree on a treatment plan to suit your needs.

Why does neuropathy develop in diabetes?

High blood glucose or sugar levels over a period of time can lead to chemical changes in your nerves, causing damage. High blood glucose levels can also damage the blood vessels that supply your nerves with oxygen. This can also damage your nerves.

What type of neuropathy can develop in diabetes?

There are three main types of neuropathy:

These can cause a variety of symptoms, depending on which part of your body is affected.

Sensory neuropathy

This is the most common type. It usually affects nerves in your feet and legs but can sometimes affect nerves in your hands and arms.

Sensory neuropathy can cause a feeling of numbness, tingling or pins and needles. Some patients develop a feeling as if they are walking over sharp stones.

Neuropathy may also cause burning pains in your legs, especially in bed at night, shooting pains, or sometimes over-sensitivity to even slight touch. This is why it's sometimes called painful neuropathy.

However, in many cases, patients may not notice any symptoms but can still have signs of sensory neuropathy when their feet are tested at the clinic. This lack of sensation can sometimes lead to problems with foot ulcers.

Taking good care of your feet is the best way to avoid foot ulcers. This is why you are advised on foot care when your diabetes is discovered

Motor neuropathy

This is less common. It might cause weak muscles, especially in your legs. It can alter the shape of your feet and cause problems with shoes. Both of these might lead to problems with walking.

Autonomic neuropathy

This affects the nerves that control internal organs and the symptoms depend on where the problem lies.

Stomach: can cause nausea or vomiting.

Intestine: can cause constipation or diarrhoea.

Bladder: can cause difficulty in passing urine.

Penis: can cause problems with erections.

Heart and blood vessels: can cause dizziness and palpitations.

Sweat glands: can cause dry skin, especially in the feet.

What should I do to avoid developing neuropathy?

You can cut your risk of developing neuropathy by keeping your blood glucose or sugar levels under control.

If you already have neuropathy, keeping blood glucose or sugar levels under control will stop it becoming worse.

How do I prevent a foot ulcer?

Is there any treatment for painful neuropathy?

Several different tablets and creams are available for this. Some will work better in some patients than in others. It's important to let your doctor know if the medication you have been prescribed isn't working or is causing side effects. If none of the tablets or creams work, then ask to be referred to the Diabetes Clinic or to the Pain Clinic, as other forms of treatment may help.

Important!

If you discover any problems with your feet, contact your podiatry service or GP immediately. If they are not available, go to your nearest after-hours GP clinic. Remember, any delay in getting advice or treatment when you have a problem can lead to serious problems.

Written by Podiatrist Special Interest Group. Endorsed by HealthInfo clinical advisers. Updated April 2016.

Source

Images courtesy of FreeDigitalPhotos.net: colourful foot by Praisaeng; stomach ache by marin.

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Review key: HIDIF-84656