Poor diabetes control can lead to diabetic neuropathies—damage to the nerves in the body. Nerves are the messengers in our body that communicate pain, temperature, and other information between our body and the brain. Their nourished tiny blood vessels are easily damaged by the effects of diabetes. There are two common types of nerve damage seen in diabetes.
Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, hands, and arms. Nerve damage in the feet makes them sensitive to pain, so you may have blisters, corns, or sores you don’t even feel.
These minor injuries can become bigger infections that can lead to the bone and require amputation. African-Americans are much more likely to suffer lower limb amputation than white or Hispanic Americans with diabetes.
The second common neuropathy is called autonomic neuropathy. This type of nerve damage causes changes in digestion, bowel and bladder function, perspiration, and sex response.
Damage to nerves in the sexual organs, causing difficulty for both men and women to experience normal sexual response. In men, the nerve damage can cause erectile dysfunction. In women, it leads to difficulty with arousal, lubrication, and orgasm.
Autonomic neuropathy can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Additionally, it can cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose—also called blood sugar, levels.
People with diabetes are also more likely to suffer from other types of neuropathy including proximal neuropathy and focal neuropathy.
Proximal neuropathy starts with pain in the thighs, hips, buttocks, or legs, usually on one side of the body. This type of neuropathy is more common in those with type 2 diabetes and older adults with diabetes. Proximal neuropathy causes weakness in the legs and the inability to go from a sitting to a standing position without help
Focal neuropathy affects specific nerves in the head, torso, or leg. It may cause inability to focus the eye, double vision, aching behind the eye, Bell’s palsy (paralysis on one side of the face), or pain in the front of the thigh, chest, stomach, shin, foot, or chest. Focal neuropathy is usually painful and unpredictable but will resolve over a few weeks or months and does not cause long-term damage.
How to Manage and Prevent Diabetic Neuropathy
The best way to prevent neuropathy is to keep blood glucose levels as close to the normal range as possible. Maintaining safe blood glucose levels protects nerves throughout the body.
If your blood glucose is elevated, the first treatment step is to bring blood glucose levels within the normal range to help prevent further nerve damage. Monitoring your blood glucose, healthy eating, physical activity, and taking your diabetes medicines or insulin as prescribed will help control blood glucose levels.
Initially, when your blood glucose is brought under control your symptoms may get worse, but over time, maintaining lower blood glucose levels helps lessen symptoms. Good blood glucose control may also help prevent or delay the onset of further problems.