by Krisha McCoy, MSEn Espaol (Spanish Version) Definition Diabetic neuropathy is a type of nerve damage associated with diabetes. It results in damage to a persons feet, legs, eyes, and bodily functions. Diabetic neuropathy can lead to serious complications. See your doctor if you suspect you have this condition. Nerves of the Foot 2008 Nucleus Medical Art, Inc. Causes Researchers believe that diabetic neuropathy is likely caused by a combination of factors, including: Metabolic problems (eg, high blood glucose) Damage to blood vesselsAutoimmune factorsGenetics Lifestyle factors (eg, smoking, alcohol use, high blood pressure) Risk Factors The following factors are thought to increase the risk of diabetic neuropathy: Older age Having diabetes for 25 years or more Having type 2 diabetesHigh blood pressureSmokingObesityLack of exercisePeripheral vascular diseaseHigh cholesterol Symptoms Symptoms of diabetic neuropathy may include: Numbness in the extremitiesTingling in the extremitiesPain in the extremitiesWasting of the muscles of the feet or handsIndigestionNausea or vomitingDiarrhea or constipationDizziness or faintnessUrination problemsImpotence or vaginal dryness Weakness in arms and or legs. Weakness of facial muscles resulting in: Drooping eyelidDrooping mouthFacial DroopDifficulty swallowing.Muscle Cramps Diagnosis Your doctor will ask about your symptoms and medical history, and perform a physical exam. Other tests may include:
- Foot examto assess sensation in the foot
- Nerve conduction studiesto test nerve activity
- Electromyographyto determine how muscles respond to nerve signals
- Quantitative sensory testingthe use of stimuli (eg, vibration) to check for neuropathy
- QSART (quantitative sudomotor axon reflex test) a test which evaluates the inervation of sweat glands.
- Heart rate teststo determine how the heart responds to changes
- Ultrasoundto view internal organs
- Biopsyto remove a sample of nerve or skin tissue for examination
Talk with your doctor about the best treatment plan for you. Treatment options include:
It is important to regularly monitor blood glucose levels. Bring them within normal range with meal planning, exercise, and/or medications.
If you have diabetic neuropathy, you will need to take special care of your feet, since the nerves in the feet are the ones most often affected by neuropathy. This care will involve regular visits to a foot doctor and careful cleaning, inspection, moisturizing, and grooming of your feet. In addition, always wearing well-fitting shoes or slippers and thick, soft, seamless socks can help protect your feet from injuries.
Other treatments will depend on your symptoms. Medications can be used to relieve pain, burning, tingling, or numbness. Oftentimes, the medications used to treat these symptoms are the same types of medications used to treat seizures and depression. Modifying your diet and/or taking erythromycin or another antibiotic can help with gastrointestinal problems. Taking care when sitting or standing, increasing salt intake, or taking medications can help manage dizziness and weakness. An antibiotic can be prescribed to treat a urinary tract infection. Medications can be used to treat erectile dysfunction, and vaginal lubricants are recommended to treat vaginal dryness.
PreventionThe best way to prevent diabetic neuropathy is to regularly monitor and manage your blood glucose levels. Your doctor can instruct you about how often to check your levels, and what the numbers mean. RESOURCES: American Diabetes Associationhttp://www.diabetes.org/ National Diabetes Information Clearinghousehttp://diabetes.niddk.nih.gov/ CANADIAN RESOURCES: Canadian Diabetes Associationhttp://www.diabetes.ca/ Health Canadahttp://www.hc-sc.gc.ca/index_e.html References: Diabetic neuropathies: the nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/.Accessed May 24, 2007. Diabetic neuropathy. DynaMed website. Available at: http://dynamed101.ebscohost.com/Detail.aspx?id=115259.Accessed May 24, 2007. Diabetic neuropathies. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000693.htm. Ogawa K, Sasaki H, Yamasaki H, et al. Peripheral nerve functions may deteriorate parallel to the progression of microangiopathy in diabetic patients. Nutr Metab Cardiovasc Dis. 2006;16:313-321. Stewart JD. Diabetic neuropathies. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. Available at: http://www.medlink.com. Accessed August 10, 2007.
Vinik AI. Diabetic neuropathies. Med Clin North Am. 2004;88:947-999. Last reviewed April 2008 by Rimas Lukas, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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