Diabetic Neuropathy

What You Need to Know

Over half of all individuals with diabetes will experience neuropathy over the course of the disease. Diabetic neuropathy typically affects the small nerves in the toes and feet, but the fingers and hands may also be affected. Diabetic neuropathy often presents as a burning, tingling, electric, or “pins and needles” sensation. The pain usually presents symmetrically, meaning both feet or both hands are affected equally. The symptoms typically affect the toes at first, but may spread to affect the feet, ankles and lower legs if the condition worsens.

Causes

Diabetic neuropathy results from years of poor glycemic control. It has been thought that elevated blood glucose can damage nerve endings by removing their natural defenses and decreasing the amount of blood and oxygen they receive. The way the body repairs nerve damage may be slowed as a result of the diabetes. The elevated glucose itself may also be directly harmful to the nerves.

Symptoms

  • Pain in toes and feet.
  • Constipation.
  • Decreased sweating.
  • Erectile and/or bladder dysfunction.
  • Rapid heart rate.
  • Sensations of burning, tingling and numbness.
  • Swelling in the lower legs.
  • Symptoms that are worsened by walking.
  • Symptoms that typically worsen at night.

Affected areas must be monitored since cuts, bruises, ulcers and other injuries to the hands and feet may not present as pain.

Better diabetic control or correction of vitamin deficiencies may result in improvement. Conditions may also be treated with oral medications and topical ointments.