Diabetic Neuropathy: The Causes, Symptoms, Risks & Treatment
Overview of Diabetic Neuropathy
Diabetic neuropathy is a painful condition that typically affects people with type 1 and type 2 diabetes, although it can also be seen in other groups. It is caused when small nerves are damaged by years of elevated blood sugar levels and can make tasks such as walking or buttoning a shirt difficult for those affected.
Diabetic neuropathy also comes with a range of symptoms, including numbness, tingling, burning sensations in the feet and hands, loss of balance and coordination, severe pain, and swollen feet. Because these symptoms can interfere with everyday activities, most people with diabetic neuropathy require medical attention. Fortunately, treatments are available to help manage pain levels and slow the progression of nerve damage.
While there are other forms of neuropathy: peripheral neuropathy, autonomic neuropathy, proximal, cranial, and focal neuropathy– this article will deal only with diabetic neuropathy. Nevertheless, here is a short summary of each of the types of neuropathy listed.
Peripheral Neuropathy
Peripheral neuropathy is the most common form of diabetic neuropathy, which affects the nerves that control the sensation and movement of the arms, hands, legs, and feet. The symptoms may range from mild numbness and tingling to severe pain and muscle weakness. In some cases, the patient may lose the ability to feel pain, temperature, or vibration, which can lead to injuries and infections.
In the feet, diabetic neuropathy can cause a loss of protective sensation, also known as diabetic peripheral neuropathy. This can result in ulcers or sores that go unnoticed and can worsen if left untreated. The risk of foot complications is higher in people with diabetes, and diabetic neuropathy can make it more challenging to manage foot health.
Autonomic Neuropathy
Autonomic neuropathy differs from diabetic neuropathy. Autonomic neuropathy affects the nerves that control important functions in the body, such as breathing, digestion, bladder, and heart. These involuntary functions take place without us needing to think about them most of the time.
Autonomic neuropathy is a nerve disorder that results in disturbances to those activities when messages from the brain and spinal cord cannot reach the affected nerves. Symptoms of autonomic neuropathy typically depend on which nerves are damaged and can range from mild to severe.
Common early signs of autonomic neuropathy are lightheadedness, feeling sick after eating or drinking certain items, and passing out when standing up very quickly. Individuals should consult their physician if they experience any of these symptoms for an appropriate diagnosis and possible treatment plan.
Proximal Neuropathy
Proximal neuropathy, also known as lumbosacral plexopathy, is a type of nerve damage that occurs in the legs and hips. It is caused by damage to the nerves located in the back near the spine.
Symptoms of this nerve damage may include muscle weakness, lack of sensation in certain areas, and pain ranging from mild to severe. Proximal neuropathy is typically diagnosed through imaging tests such as an MRI or CT scan.
Treatment options for proximal neuropathy vary depending on the severity of nerve damage but might include physical therapy, medications, or even surgery. Proximal neuropathy can be a debilitating condition but with proper diagnosis and treatment, individuals can often return to their normal activities.
Cranial Neuropathy
Cranial neuropathy is a type of nerve disorder impacting the nerves located in the head and neck. This neurological condition can cause weakness, numbness, and a loss of sensation in the face, as well as problems with hearing and vision.
Cranial Neuropathy can be caused by various illnesses such as diabetes or strokes. It can also be caused by physical trauma such as head injuries or even minor infections such as shingles.
Focal Neuropathy
Focal Neuropathy is a condition where there is damage to single or multiple nerve(s) in the body. It results in pain and numbness that affects only one side of the body, usually some part of the face or an arm or leg, but occasionally can affect other organ systems.
Common causes include diabetes, Lyme disease, and certain medications. Symptoms vary amongst individuals and may include sharp electric shock-like pain, muscle weakness, burning sensations and numbness.
Diagnosis is attempted by both physical examination and electrodiagnostic tests like electromyography (EMG) and/or nerve conduction velocity (NCV).
Treatment often involves physical therapy, occupational therapy, medications including anticonvulsants for pain relief as well as vitamins such as B-12 for many cases.

Diabetic Neuropathy & High Blood Sugar
Diabetes is a serious condition with potentially devastating effects on the body, one of which is diabetic neuropathy. High blood sugar levels can cause nerve damage, leading to chronic pain, tingling sensations in extremities, and loss of strength. Over time, this kind of nerve damage caused by high glucose levels in diabetes can become so severe that amputations may be necessary in order to preserve the health and safety of patients.
Furthermore, high blood sugar in diabetes often lead to other serious complications such as vision deterioration or urinary tract infection due to impaired circulation or sensation in these areas. Sufferers are encouraged to actively manage their condition through diet and exercise in order to control their blood sugars and thereby limit any potential, damaging effects on their neuropathy.
Symptoms
Symptoms can vary widely, depending on the area of the body affected, but some common indications include a lack of sensation or feeling in various parts of the body such as the feet or hands, muscle weakness, spasms or cramps, severe pain or burning, tingling pain in various areas, slow healing or ulcers overlying nerve damage, and numbness.

Risk Factors
Diabetic neuropathy can lead to a number of complications if not managed properly. Factors that increase the risk of developing this condition include inadequate blood glucose control for an extended period of time, an existing kidney condition such as chronic kidney disease or nephropathy, being overweight and/or sedentary lifestyle, smoking, having a family history of diabetic neuropathy, advancing age, use of hypertension medications and certain other drugs such as chemotherapeutic agents or alpha-lipoic acid.
It is therefore important to monitor any potential risk factors to catch and address the symptoms at their early stages to prevent severe complications.
Diabetic Neuropathy Diagnosis
Diagnosing diabetic neuropathy can be a challenging process, since many of the symptoms experienced by patients can easily be attributed to other conditions. It is important for doctors to look at the patient’s medical history and lifestyle habits, with special attention focused on risk factors such as obesity, poor nutrition, high glucose levels, and smoking.
Symptoms such as numbness or tingling in the extremities should also be evaluated carefully and considered alongside signs of active inflammation of the nerves. By carefully assessing patient history and symptoms through multiple diagnostic tools, it is possible for physicians to accurately diagnose diabetic neuropathy.

Tests for Diabetic Neuropathy
For people suffering from diabetic neuropathy, the key to managing symptoms is undergoing comprehensive testing to diagnose, and potentially treat, the condition. At the start of any diagnosis for diabetic neuropathy, a patient’s primary care team will likely perform laboratory tests and imaging tests in order to gain a better understanding of any potential nerve damage.
These tests can include blood levels that measure sugar and other chemical molecules circulating throughout the body. Laboratory results should be followed-up with more specialized nerve condition tests to pinpoint areas of pain or extreme sensitivity in order to form an effective treatment plan.
Ultimately, any diagnosis of diabetic neuropathy should include both laboratory tests and imaging tests in order to provide an accurate assessment of any nerve damage or imbalances you are facing.
Treatment Options
Medications
Though most medical treatments focus on controlling overall blood sugar levels, there are a number of drugs that specifically target diabetic neuropathy pain. These medications often take the form of topical creams, anticonvulsants, and anti-depressants; for more severe cases nerve pain inhibitors or even opioids may be necessary.
It is important to consult with your doctor about which medications are necessary and appropriate for your individual case in order to safely treat the uncomfortable symptoms associated with diabetic neuropathy.
Physical Activity
Physical activity can be used as an effective treatment to reduce the discomfort caused by diabetic neuropathy. Doing gentle cardio activities such as walking or swimming are good ways to begin managing diabetic neuropathy.
Although tough-looking exercises can seem intimidating, they can help improve diabetic neuropathy symptoms over time by strengthening muscles and increasing circulation.
Exercise also has numerous other health benefits; studies have indicated that it may improve balance and reflexes that are weakened due to nerve damage from the disease. No matter the activity you choose, start slow and listen to your body.
Dietary and Lifestyle Changes
Managing the symptoms of diabetic neuropathy can be a challenge, but with a commitment to dietary and lifestyle changes, it is possible. Eating healthy and exercising regularly helps to maintain healthy blood glucose levels, which reduces the impact of neuropathy. It’s also helpful to avoid activities that put large amounts of strain on your body, such as sitting in one position for a long time or lifting heavy objects.
Additionally, keeping yourself hydrated is imperative; dehydration can exacerbate pain associated with neuropathy as well as cause other adverse related side effects. With regular physician visits and adherence to these changes, a person living with diabetic neuropathy can successfully manage their symptoms and increase the quality of their life.

Alternative Medicine
While traditional medicine treatments exist for this condition, some people have turned to alternative therapies for relief and symptom management.
Along with yoga and exercise, dietary interventions, specific supplements, acupuncture, manual manipulation, and herbal remedies may provide an additional layer of support in treating diabetic neuropathy.
It is important to note that these alternative approaches should be discussed with a qualified healthcare provider prior to implementation in order to best address individual needs.
Surgery
When it comes to treating diabetic neuropathy, doctors will often recommend lifestyle changes such as physical activity and stress management. However, surgery is sometimes needed if these more conservative measures fail to provide sufficient relief. While rare, there are surgical procedures available that can effectively alleviate pain caused by diabetic neuropathy.
Neurolysis is one procedure that entails the blocking of certain targeted nerves while preserving those needed to move the patient’s muscles; another option is neuromodulation which uses physical stimulation or drugs to improve circulation and nerve function.
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Resources for More Information
Fortunately, there are many resources available to educate yourself on the condition and gain insight into how you can delay diabetic neuropathy or how it can be managed.
Research suggests that partnered care between health professionals and diabetic patients is necessary to effectively manage the condition and its potential complications. To this aim, online support groups, forums, and websites offer an abundance of information, including personalized advice from experts in diabetic medicine.
Additionally, non-profit organizations such as the American Diabetes Association provide resources specifically related to diabetic neuropathy such as educational seminars and opportunities for advocacy. Overall, there is no shortage of information available.
Here are five additional online sources of information about diabetic neuropathy:
1. “Diabetic Neuropathy: Symptoms, Treatment, and Prevention” by the Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580
2. “Diabetic Neuropathy: Introduction” by the American Diabetes Association: https://www.diabetes.org/diabetic-neuropathy
3. “Diabetic Neuropathy” by the National Institute of Diabetes and Digestive and Kidney Diseases: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies
4. “Diabetic Neuropathy: An Overview” by The Journal of Clinical Endocrinology & Metabolism: https://academic.oup.com/jcem/article/97/6/1609/2545584
5. “Diabetic Neuropathy” by the American Association of Neuromuscular & Electrodiagnostic Medicine: https://www.aanem.org/patients-and-public/diabetic-neuropathy-overview
In addition, I have another article about how to reduce blood sugar naturally that you may find helpful.

Conclusion
In conclusion, diabetic neuropathy is a serious condition caused by high blood glucose levels that can lead to nerve damage and other complications. While lifestyle changes such as diet, exercise, and stress reduction are essential, there are also alternative treatments and surgical procedures available depending on the severity of the symptoms. Additionally, there are a plethora of resources available online.
Disclaimer
The information provided in this article should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health providers regarding a medical condition.