Diabetic Neuropathy

Overview

What is diabetic neuropathy?

Diabetic neuropathy is a type of nerve damage that happens in people who have diabetes. This damage makes it hard for their nerves to carry messages to the brain and other parts of the body.

Portions of this article were developed by the American Academy of Family Physicians in cooperation with the American Diabetes Association.

Symptoms

What are the symptoms of diabetic neuropathy?

Diabetic neuropathy can cause the following symptoms:

  • Numbness (loss of feeling) or painful tingling and burning in parts of the body, especially your fingers, toes, hands or feet
  • Muscle weakness and difficulty walking
  • Cuts, sores or blisters on your feet that don’t hurt as much as you would expect, and that also heal very slowly
  • Bladder problems such as urinary tract infections and urinary incontinence (the loss of bladder control)
  • Digestive problems such as bloating, abdominal pain, constipation, nausea, vomiting and diarrhea.
  • Erectile dysfunction (in men) and vaginal dryness (in women)

Causes & Risk Factors

What causes diabetic neuropathy?

Diabetes causes the level of sugar in your blood to be higher than normal. Over time, high blood sugar levels damage the blood vessels and nerves. That’s why people who don’t control (or can’t control) their blood sugar very well seem more likely to get diabetic neuropathy.

Men are more likely to have diabetic neuropathy than women. High cholesterol levels and smoking also increase your risk.

Prevention

What can I do to avoid diabetic neuropathy?

The most important thing is to keep your blood sugar under control. Take your medicines and/or insulin exactly as your doctor prescribes. Eat a healthy diet. If you are overweight, ask your doctor to help you lose weight. Get plenty of exercise.

What can I do to prevent foot problems from diabetic neuropathy?

Keep your blood sugar level as close to normal as possible. Also, follow your doctor’s advice on diet and exercise. Take your insulin or medicine exactly as prescribed. Here are some other ways to protect your feet:

  • Wash your feet every day with lukewarm (not hot) water and mild soap.
  • Dry your feet well, especially between the toes. Use a soft towel and pat gently; don’t rub.
  • Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it.
  • Keep your feet dry by dusting them with nonmedicated powder before putting on shoes, socks or stockings.
  • Check your feet every day. You may need a mirror to look at the bottoms of your feet. Call your doctor if you have redness, swelling, pain that doesn’t go away, numbness or tingling in any part of your foot.
  • Don’t treat calluses, corns or bunions without talking to your doctor first.
  • Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them. File the edges of your toenails carefully.
  • Don’t let your feet get too hot or too cold.
  • Don’t go barefoot.

What should I look for when choosing shoes and socks?

  • Don’t wear shoes without socks.
  • Don’t wear sandals or other open-toed shoes.
  • Avoid high-heeled shoes and shoes with pointed toes.
  • Wear well-padded socks or stockings that are 1/2 inch longer than your longest toe. Don’t wear stretch socks, nylon socks, socks with an elastic band or garter at the top, or socks with inside seams.
  • Don’t wear uncomfortable or tight shoes that rub or cut into your feet. If you’ve had problems before because of shoes that didn’t fit, you may want to be fitted for a custom-molded shoe.
  • Talk to your doctor before you buy special shoes or inserts.
  • Shop for new shoes at the end of the day when your feet are a little swollen. If shoes are comfortable when your feet are swollen, they’ll probably be comfortable all day.
  • Break in new shoes slowly by wearing them for no more than an hour a day for several days.
  • Change socks and shoes every day. Have at least 2 pairs of shoes so you can switch pairs every other day.
  • Look inside your shoes every day for things like gravel or torn linings. These things could rub against your feet and cause blisters or sores.

How often will my doctor check my feet?

Your doctor or nurse should check your feet periodically when you go in for a visit. If you are having any problems, such as numbness, sores or ingrown toenails, tell your doctor right away.

Treatment

How is diabetic neuropathy treated?

There is no cure for diabetic neuropathy. Treatment focuses on slowing the development of the condition through controlling blood sugar levels and making lifestyle changes. These lifestyle changes not only help slow nerve damage, but also promote overall health. They include:

Treatment for diabetic neuropathy also focuses on relieving pain and discomfort. There are several medicines available that help ease neuropathy pain. Your doctor will help you decide which is the best for you.

  • Eating a healthy diet
  • Exercising regularly
  • Maintaining a healthy weight
  • Controlling blood pressure
  • Not smoking
  • Limiting alcohol use

Complications

What will happen if the nerves in my legs and feet are damaged?

If diabetic neuropathy has damaged the nerves in your legs and feet, you may not be able to feel pain in those parts of your body. This is a problem because pain can be a useful signal. If you have no feeling in your feet, you could have an injury and not know it. In addition, your muscles might atrophy (decrease in size), and make it difficult for you to walk. The skin on your feet might crack and develop sores. If these sores do not heal or become infected, they might need to be treated at a hospital. In severe cases, you may need to have your foot amputated (removed). Because diabetes makes it harder for an injury to heal, it’s important to take good care of your feet and prevent injuries in the first place.

Other Organizations

Questions to Ask Your Doctor

  • I haven’t been diagnosed with diabetes, but my feet are numb and sometimes tingle. Should I be tested for diabetes?
  • Should I wear high heeled shoes?
  • If I get a sore on my foot, should I see my doctor immediately, or is it okay to monitor it myself?
  • Can you recommend a good lotion for my feet?
  • I’ve had some problems with bladder control. Is there anything I can do to help my control?
  • Will my neuropathy ever get better?
  • Are there any medicines I can take to stop the pain?

Portions of this article were developed by the American Academy of Family Physicians in cooperation with the American Diabetes Association.  Portions of this article were developed as part of an educational program made possible by an unrestricted educational grant from LifeScan, Inc., makers of OneTouch Blood Glucose Meters.  Portions of this article were developed with general underwriting support from The Coca-Cola Company.