The Nerve Complications (Neuropathy)

People with diabetes can and should expect to live a full and normal life with diabetes as free as possible of the complications of diabetes. There are a number of such complications, one of which is an affect on the nerves.

What is Neuropathy?

By “Nerves” it is not meant how much you worry – it’s not the same as being nervous which is about being anxious. As you probably know, the nerves are cords that carry small electric messages fro the brain to the body that allow the brain to control the body.

Neuropathy is damage to the nerves that travel between the brain and the spinal cord to the muscles, skin and other parts of the body. Neuropathy can be caused by diabetes, but it can be caused by other illnesses, a poor lifestyle and the nerve function does get slower as we get older.

Why does neuropathy develop in diabetes?

High blood sugar levels over a period of time lead to chemical changes in the nerves and can also block the very small blood vessels that supply the nerves with oxygen. This can damage the nerves.

What types of neuropathy can develop in diabetes?

There are three main types: Sensory, Autonomic and Motor.

Sensory neuropathy

It is the most common type and mainly affects the nerves in the feet and legs and occasionally the hands. This can cause feeling of numbness, tingling or ‘pins and needles’. Some people may develop a feeling as if they are walking over sharp stones. Neuropathy may also cause burning pains in the legs, especially in bed at night, shooting pains or sometimes over-sensitivity to even slight touch. Your balance may be affected and you may stumble for no reason.

People with numb feet are at a greater risk of injury which they are not aware of. Taking good care of your feet is the best way to avoid foot ulcers.

Autonomic neuropathy

It is less common. It affects the organs which work without us being aware of them- the stomach, bowels, heart, bladder and sweat glands. This may cause a problem with bladder and bowel function or difficulties in digesting food including unexplained vomiting.

Motor neuropathy

Whilst this is common, it is quite rare for it to be so bad as to cause symptoms in its own right. It might cause weakness of muscles especially in the legs and hands. It can alter the shape of the feet and cause problems with shoes which might lead to problems with walking and to foot ulcers. In the hands, you may get weakness that causes difficulty with day-to-day task and also with injecting insulin and blood testing.

What can I do to prevent developing neuropathy?

You could cut down your risk of developing neuropathy by keeping your blood sugar levels under control. If you already have neuropathy, keeping blood sugar levels under control will prevent it becoming worse.

Drinking excess alcohol can make matters much worse because that also damages the nerves. Smoking affects the circulation and poisons the nerves so that to is again harmful. A poor diet may lead to poor nutrition that can cause damage.

How do I prevent a foot ulcer?

Follow the foot care advice given by your Podiatrist/ Chiropodist, nurse or GP. Attend the chiropodist regularly. You may need to be referred to an Orthotist to provide you with appropriate footwear.

Is there any treatment for painful neuropathy?

As well as getting good control of your diabetes, there are a number of medical treatments available. Treating the pain from diabetic neuropathy takes patience and persistence. The most important thing is to take the treatment regularly even if the pain has lessened. If none of the pain relief tablets work, ask to be referred to the diabetes clinic or to the pain clinic. .

Seeking Advice and what care to expect

You should be examined regularly to see if neuropathy is developing – usually this is done when your feet are tested for feeling. If you have neuropathy, you will get special advice on how to care for your feet. Your medical team will also look for other conditions that can cause nerve damage such as circulation problems, vitamin deficiencies or thyroid problems and they will advise you about your lifestyle. If you have problems with pain, they will consider tablet and other treatments for this.