Understanding Diabetic Neuropathy

What is Diabetic Neuropathy?

If you have diabetes, a type of nerve damage called diabetic neuropathy may occur. It is caused by a large amount of blood sugar in your system that injures nerves throughout your body. High blood pressure also weakens the walls of small blood vessels that supply the nerves with oxygen and nutrients, according to Mayo Clinic.

What are the symptoms?

The symptoms for diabetic neuropathy vary depending on the type that you have. There are four main types and each have different symptoms.

  • Peripheral Neuropathy
    • This is the most common type. It first affects the feet and legs then moves on to the hands and arms. Symptoms may be worse at night. Symptoms include:
      • Numbness, temperature changes in feet or legs, loss of feeling
      • Tingling or burning in nerve damaged area
      • Pains or cramps
      • Muscle weakness
      • Difficulty balancing
      • Sensitive to touch
      • Loss of reflexes
      • Ulcers, infections, bone and joint pain
  • Autonomic Neuropathy
    • The autonomic nervous system controls many parts of your body including; heart, bladder, stomach, intestines, sex organs and eyes. If diabetes affects these nerves it could possible cause:
      • Unawareness of low blood sugar
      • Bladder problems
      • Constipation or uncontrolled diarrhea
      • Gastroparesis or slow stomach emptying
      • Difficulty swallowing
      • Uncontrolled sweating
      • Increase heart rate at rest
      • Difficulty with eyes adjusting to light
      • Light headedness or faintness after sitting or standing due to sharp drops in blood pressure
      • Decrease sexual response
  • Radiculoplexus Neuropathy (diabetic amyotrophy)
    • This type of neuropathy affects the nerves in the thighs and hips, as well as buttocks or legs. Symptoms are usually on one side of the body and are more common in older adults with type 2 diabetes. Symptoms Include:
      • Severe pain in hip, thigh or buttocks
      • Weakness and shrinking thigh muscles
      • Difficult standing
      • Abdominal swelling
      • Weight loss
  • Mononeuropathy
    • This nerve damage is specific to nerves in the face, torso or leg. It can strike suddenly and cause severe pain, but usually does not leave lasting effects. Symptoms include:
      • Pain in the shin or foot
        • Lower back or pelvis
        • Front of thigh
        • Chest or abdomen
      • Difficult focusing
      • Blurred vision
      • Aching behind the eye
      • Paralysis on one side of the face

What are the risk factors?

Diabetes is the primary risk factor for diabetic neuropathy, but there are others that increase your risk of developing it.

  • Kidney disease: Kidney damage, caused by diabetes, sends toxins into the blood, which may lead to nerve damage.
  • Being overweight: Having a body mass index of greater than 24 constitutes as being overweight. This can increase your risk of diabetic neuropathy.
  • Smoking: Smoking narrows your arteries reducing blood flow to your feet and legs. This makes wounds harder to heal and can cause nerve damage to your feet and legs.

How does it lead to amputation?

Having nerve damage due to neuropathy can severely impact feeling in your legs or feet. This can worsen a patient’s ability to feel or recognize a small cut on their foot. If the wound is left untreated it can cause infections that spread to the bone, and ulcers can lead to tissue death.  In many cases, this results in loss of toes, foot or even the lower parts of the leg.

Amputation is NOT your only option. If you are told this, please call 904.493.3333 to see how the Amputation Prevention Center at First Coast Cardiovascular Institute can help you.

How can it be prevented?

Luckily, there are ways to prevent or delay diabetic neuropathy. This first way is to check your blood and glucose level regularly. This is the number one tactic you can do to reduce your risk of amputation. Another important tactic is to check your feet and legs every day. Before getting into bed do a quick check for cuts or wounds. You may not feel a wound happen, so it is important to check before it becomes too late. Grab a hand mirror to make sure you can examine your entire foot.