Diabetic Neuropathy Overview

What Is Diabetic Nerve Pain?

Written by Daniel J. Toft MD, PhD

Diabetes can damage nerves throughout your body. In fact diabetic neuropathy (neuro- means nerves; -pathy means disease or suffering) is the most common, chronic complication of diabetes according to the American Diabetes Association.It affects 60-70% of people with type 1 and type 2 diabetes, according to the National Institute of Diabetes and Digestive and Kidney Disease. 2

Diabetic neuropathy can be extremely painful. It can also pave the way for health-threatening and even life-threatening problems including foot ulcers, amputations, heart attacks, digestion problems and difficulty recognizing low blood sugar episodes. While it cannot be cured, smart lifestyle steps may prevent diabetic neuropathy for some people and slow its progression for others. Medications and other approaches can treat symptoms, such as pain. And awareness—through steps like good foot care, regular foot exams and telling your doctor about other symptoms—can help prevent this blood-sugar-related nerve damage from spiraling into even more serious health issues.

The best-known type of diabetic neuropathy is called diabetic peripheral neuropathy. It can cause burning, stabbing or electric-shock-type pain or tingling in your feet, legs, hands or arms. The pain may be worse at night; treatment options range from over-the-counter patches to prescription drugs.  

But there’s growing evidence that diabetes causes deeper nerve damage that affects more people with high blood sugar than experts once understood. Other types of diabetic neuropathy include:

The precise cause of diabetic neuropathy isn’t fully understood. Researchers believe that it’s related to high blood glucose (blood sugar). Inflammation, high cholesterol, and immune-system changes may also play important roles.  You’ll learn more about blood glucose and other causes of neuropathy in the article on diabetic neuropathy causes.

Diabetes-related nerve damage worsens with age and with advancing diabetes. About one in three people with type 1 diabetes had signs of diabetic neuropathy 25 years after their diabetes was first diagnosed in one large study from Manchester Royal Infirmary in the UK, published in the journal Diabetologia. 11 Half of those with type 2 diabetes have neuropathy ten years after their diagnosis, 12 according to a 2014 University of Michigan review in the journal Current Diabetes Reports.  

But diabetic neuropathy also affects children, teens and young adults with diabetes. And there’s growing evidence that nerve damage can begin early in diabetes.  According to the American Diabetes Association, 10-20% of people with prediabetes have signs of diabetic neuropathy, too. 

Staying Ahead of Diabetic Neuropathy

A few helpful tips to keep you on top of and in tune with your foot health: 

 

Sources

1. Pop-Busui R et al: Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017;40:136–154. http://care.diabetesjournals.org/content/diacare/40/1/136.full.pdf

2. National Institute of Diabetes and Digestive and Kidney Disease. Diabetic neuropathies: The nerve damage of diabetes. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/diabetic-neuropathies-nerve-damage-diabetes/Pages/diabetic-neuropathies-nerve-damage.aspx. Accessed March 6, 2017.

3. Pop-Busui R et al: Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017;40:136–154. http://care.diabetesjournals.org/content/diacare/40/1/136.full.pdf

4. Pop-Busui R et al: Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017;40:136–154. http://care.diabetesjournals.org/content/diacare/40/1/136.full.pdf

5. Miller: How to do a 3-minute diabetic foot exam. The Journal of Family Practice, November 2014,  Vol 63, No 11.  http://www.mdedge.com/jfponline/article/88218/diabetes/how-do-3-minute-diabetic-foot-exam/pdf

6. Shojaiefard A et al. Independent risk factors for amputation in diabetic foot. Int J Diabetes Dev Ctries. 2008 Apr-Jun; 28(2): 32–37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772008/

7. Pop-Busui R et al: Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017;40:136–154. http://care.diabetesjournals.org/content/diacare/40/1/136.full.pdf

8. Verrotti A et al. Autonomic neuropathy in diabetes mellitus. Front. Endocrinol., 01 December 2014 | https://doi.org/10.3389/fendo.2014.00205

9. National Institute of Diabetes and Digestive and Kidney Disease. Diabetic neuropathies: The nerve damage of diabetes. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/diabetic-neuropathies-nerve-damage-diabetes/Pages/diabetic-neuropathies-nerve-damage.aspx. Accessed March 6, 2017

10. MedlinePlus: Mononeuropathy. Reviewed May 30, 2016. Accessed March 6, 2017. https://medlineplus.gov/ency/article/000780.htm

11. Young MJ et al.   A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993;36:150–154. https://www.ncbi.nlm.nih.gov/pubmed/8458529

12. Ang L et al. Glucose control and diabetic neuropathy: lessons from recent large clinical trials. Curr Diab Rep 2014;14:528. https://www.ncbi.nlm.nih.gov/pubmed/25139473

13. Verrotti

14. Patil: Opioid Use in the Management of Diabetic Peripheral Neuropathy (DPN) in a Large Commercially Insured Population. Clin J Pain . 2015 May ; 31(5): 414–424.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391274/pdf/nihms602471.pdf

15. Miller: How to do a 3-minute diabetic foot exam. The Journal of Family Practice, November 2014,  Vol 63, No 11.  http://www.mdedge.com/jfponline/article/88218/diabetes/how-do-3-minute-diabetic-foot-exam/pdf

16. Patil: Opioid Use in the Management of Diabetic Peripheral Neuropathy (DPN) in a Large Commercially Insured Population. Clin J Pain . 2015 May ; 31(5): 414–424.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391274/pdf/nihms602471.pd

 

 

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