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Diabetic Neuropathy FAQs

Reviewed by Melissa Conrad Stöppler, MD

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Q:What is diabetic peripheral neuropathy?

A:Diabetic peripheral neuropathy is the medical term for nerve damage that is caused by diabetes.

The term "neuropathy" refers to any type of nerve damage. More specifically, the terms "diabetic peripheral neuropathy" or "diabetic neuropathy" refer to damage caused by diabetes to the peripheral nervous system. Peripheral neuropathy causes numbness, loss of sensation, and pain, tingling or burning sensations and primarily affects the arms and legs. It has been estimated that about 50% of people with diabetes have some form of nerve pain. Diabetic neuropathy is most common in people who have had diabetes for at least 25 years.

Peripheral neuropathy is the most common complication of diabetes.

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Q:How are nerves damaged from diabetes?

A:With diabetes, nerves suffer from lack of oxygen.

Diabetes damages blood vessels throughout the body. Some of these blood vessels are responsible for bringing oxygen to the nerves and nerve coverings of the peripheral nerves. Damaged nerves do not function effectively to relay messages to the brain and other areas of the body. The damaged nerves may send signals at the wrong time, send inappropriate or incorrect signals, send signals too slowly, or fail to transmit signals at all. This pattern of inappropriate signaling by the peripheral nerves causes the symptoms of peripheral neuropathy like weakness, numbness, and loss of balance. Sensations such as heat, cold, and pain may not be felt, and abnormal sensations such as burning or tingling may be experienced.

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Q:Diabetic peripheral neuropathy is avoidable. True or False?

A:True.

Most people with diabetes will eventually develop neuropathy of some type. However, research has shown that the risk of developing neuropathy can be reduced or prevented in people with diabetes by keeping good control over blood sugar levels. Stable control of blood sugar is the most important factor in preventing diabetic neuropathy.

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Q:Why is diabetes troublesome for the feet?

A:Diabetes can be troublesome for the feet because it can cause numbness in the feet, and can deprive the feet of nutrients and oxygen, which increases the risk for infections and ulcers from injuries.

Diabetic neuropathy can have potentially serious consequences for the feet. The nerve damage and loss of sensation increases the risk of infection, ulcers, and sores. The problems with circulation due to damaged blood vessels only increase the risk of foot problems in people with diabetes. Decreased circulation to the feet deprives the feet of oxygen and nutrients that help speed healing. If people with diabetes have numbness, injuries to the feet may not be felt. Serious infections can result when sores, infection, or other injuries or trauma to the feet are not properly treated.

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Q:For people with diabetes, what is the best way to care for the feet?

A:It is important for people with diabetes to make healthy lifestyle choices no matter what, but this is especially true when it comes to caring for the feet.

Below are some tips for foot care for people with diabetes or diabetic peripheral neuropathy:
1. Regularly examine your feet for sores or injuries.
2. Wear comfortable footwear that do not rub or cause blisters.
3. Use warm water — not hot water — for washing.
4. Never go barefoot.
5. Protect your feet from temperature extremes.
6. Moisturize the feet, but do not apply moisturizer between the toes.
7. Cut your toenails once per week.

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Q:What is a serious consequence of untreated peripheral neuropathy?

A:Amputation is a serious consequence of untreated neuropathy.

As previously discussed, people with diabetes must always take proper care of their feet and inspect their feet regularly. One reason for this is that peripheral neuropathy can lead to numbness. This means that if an injury to the feet occurs, it may not be felt or noticed. Lack of care for this injury can lead to a serious infection that will not heal, resulting in amputation of the foot in the most severe cases.

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Q:Often seen with diabetes, what other diseases of automatically functioning nerves?

A:Other diseases of automatically functioning nerves are called autonomic neuropathy and visceral neuropathy.

Autonomic neuropathy is a different type of nerve damage that occurs in people with diabetes. It refers to damage to the nerves that regulate the internal organ systems such as bladder muscles, the digestive system, and the heart. Autonomic neuropathy can cause these important organ systems to malfunction. Some of the resulting symptoms can include diarrhea, constipation, urinary incontinence, erectile dysfunction, or dizziness. Another term sometimes used to refer to autonomic neuropathy is visceral neuropathy. "Viscera" is the medical term for "internal organs."

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Q:Diabetic peripheral neuropathy can be cured. True or False?

A:False.

Although there is no cure for diabetic peripheral neuropathy, treatments are available to help control the symptoms of diabetic nerve pain. Medications that can work to control nerve pain include certain types of medications such as (pregabalin) Lyrica®, duloxetine (Cymbalta®), and certain anti-seizure medications. Additionally, capsaicin and lidocaine in topical form may be applied to the affected area to relieve pain.

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