Nerve Damage

Diabetic neuropathy, or nerve damage, impacts up to 70% of people with diabetes. The biggest risk factor for developing neuropathy is uncontrolled blood glucose levels, and the incidence of neuropathy in diabetes increases with time. Those who have lived with diabetes for 25 years or longer are more likely to have some degree of neuropathy, although symptoms are not always present.

Cardiovascular problems may also play a part in the development of neuropathy. People with high blood pressure and high cholesterol are at higher risk for developing neuropathy, presumably due to blood vessel damage and resulting poor blood circulation that deprives nerves of oxygen. Lifestyle factors, such as smoking or alcohol use, may also be a cause of nerve damage.

Neuropathies can affect the peripheral nerves of the arms, hands, legs, and feet (known as peripheral neuropathy) and they can also impact organ system function (known as autonomic neuropathy). There are also proximal neuropathies that can cause pain in the thighs, hips, or buttocks and focal neuropathies that damage a single nerve or nerve group, resulting in weakness and/or pain in a focused area. The primary symptoms of all neuropathies except autonomic are tingling, numbness, and/or pain in the affected area. Other symptoms of nerve damage may include indigestion, nausea, or vomiting; diarrhea or constipation; dizziness or faintness due to a drop in blood pressure after standing or sitting up; problems with urination; erectile dysfunction in men or vaginal dryness in women; and weakness. Weight loss and depression are not neuropathy-related symptoms, but often accompany it.

Doctors generally diagnose neuropathy on the basis of symptoms and a physical exam, which may include checking blood pressure, heart rate, reflexes, muscle strength, and sensitivity to vibration, light touch, temperature, or position changes.

The best way to prevent neuropathy is to maintain safe blood glucose levels, which will protect the nerves throughout the body.

Reviewed by Francine Kaufman, MD. 4/08