Diabetic Neuropathy

What is neuropathy?

• Neuropathy is damage to the nerves that travel between the brain and spinal cord to the muscles, skin and other parts of the body.
• Neuropathy can be caused by diabetes, but it can sometimes be caused by other illnesses.

Why does neuropathy develop in diabetes?

• High blood glucose (sugar) levels over a period of time can lead to chemical changes in the nerves that causes damage.
• High blood glucose levels can also damage the blood vessels that supply the nerves with oxygen. This can also cause the nerves to become damaged.

What type of neuropathy can develop in diabetics?

There are 3 main types:

• Sensory
• Motor
• Autonomic

Sensory Neuropathy

• This is the most common type.
• It usually affects nerves in the feet and legs but can sometimes affect nerves in the hands and arms.
• Sensory neuropathy can cause a feeling of numbness, tingling or ‘pins and needles’.
• Some patients 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. This is why it is sometimes called “Painful Neuropathy”.
• However in many cases, patients may not notice any symptoms but can still have signs of sensory neuropathy when their feet are tested at the clinic.
• This lack of sensation can sometimes lead to problems with foot ulcers.
• Taking good care of the feet is the best way to avoid foot ulcers. This is why you are advised on foot care when your diabetes is discovered.

Motor Neuropathy

• This is less common
• It might cause weakness of muscles especially in the legs
• It can alter the shape of the feet and cause problems with shoes
• Both of these might lead to problems with walking

Autonomic Neuropathy

This affects the nerves that control internal organs and the symptoms depend on where the problem lies:

Stomach: can cause nausea or vomiting.

Intestine: can cause constipation or diarrhoea.

Bladder: can cause difficulty in passing urine.

Penis: can cause problems with erections.

Heart and blood vessels: can cause dizziness and palpitations.

Sweat glands: can cause dry skin, especially in the feet.

What should I do to avoid developing neuropathy?

• You can cut your risk of developing neuropathy by keeping your blood glucose (sugar) levels under control.
• If you already have neuropathy, keeping blood glucose (sugar) levels under control will prevent it becoming worse.

How do I prevent a foot ulcer?

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

 Is there any treatment for painful neuropathy?

A variety of tablet treatments are available for this. Some tablets will work better in some patients than in others. It is important to let your Doctor know if the tablets that you have been prescribed are not working or are causing side effects. If none of the tablets work, then ask to be referred to the Diabetes Clinic or to the Pain Clinic, as other forms of treatment such as acupuncture, may be beneficial.