Neuropathy

Discover how diabetes can affect the nervous system.

What is Neuropathy?

Some people already present some type of neuropathy when diagnosed with type 2 diabetes.

Neuropathy is an attack on the nervous system. It is one of the complications of diabetes. When blood glucose (sugar) levels stay high for an extended period of time, it can damage the nerves, particularly the nerves in the lower limbs (peripheral neuropathy). Certain organs can also be affected, such as the heart, genitals, stomach, intestines and bladder.

Signs and symptoms

Neuropathy can occur in numerous and various ways depending on where it develops in the body.

Symptoms in the feet and toes:

  • Reduction or loss of feeling (to pain, to heat, to cold)
  • Numbness
  • Tingling, burning sensation

Other possible symptoms:

  • Undetected hypoglycemia
  • Gastroparesis (a stomach disorder that delays gastric emptying, which can cause bloating, heartburn and even unstable blood glucose levels (glycemia))
  • Constipation/diarrhea
  • Hyperactive bladder (increase in frequency and urgency, and urinary incontinence) or neurogenic bladder (loss of sensation indicating the bladder is full and incomplete voiding when urinating)
  • Erectile dysfunction

Risk factors for neuropathy

The factors that increase the risk of neuropathy are:

  • High blood glucose (sugar) levels (glycemia)
  • A high level of blood triglycerides
  • Being overweight
  • Smoking
  • High blood pressure (hypertension)
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Preventing Neuropathy

The primary way to prevent neuropathy is excellent glycemic control.

Prevention

The main prevention method is excellent control of your glycemia. There are, however, a few other ways to prevent or delay the onset of neuropathy, or even slow down the progression of the disease:

Adopt healthy lifestyle habits:

Let your doctor know if you experience any:

  • urinary problems
  • digestive problems
  • erectile problems
  • undetected hypoglycemia
  • enderness, pain or abnormal sensations in the legs or feet

Pay particular attention to peripheral neuropathy

The main danger of nerve damage with loss of sensation in your legs is the risk of foot injury without noticing it. Such an injury could become infected and, when blood circulation is compromised, lead to gangrene and amputation.

To limit these risks, you should:

  • examine your feet daily for minor cuts, blisters or sores
  • see your doctor, a podiatrist or a foot-care nurse every year or when foot abnormalities occur
  • follow proper foot-care procedures every day
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Neuropathy Screening and Treatment

Screening

A doctor, podiatrist or foot-care nurse can test for neuropathy in your lower limbs by lightly pressing a thin nylon rod to different areas of your foot or by placing a tuning fork on the back of your big toe to determine if you can feel the vibration. A doctor can also use an electromyogram (EMG) to confirm the diagnosis.

Screening frequency
Type 1 diabetes 5 years after diabetes diagnosis, then every year thereafter.

For a child diagnosed with diabetes before puberty: first screen 5 years after puberty, then every year thereafter.

Type 2 diabetes Type 2 diabetes

At diabetes diagnosis, then every year thereafter.

Treatment for neuropathic pain

If it becomes very painful, if it interferes with your sleep or negatively affects your quality of life, you should consider taking medication to lessen the symptoms. Talk to your doctor or pharmacist.

 

Research and adaptation: Diabetes Québec Team of Health Care Professionals

December 2014

 

References:

“Nerve Damage (Diabetic Peripheral Neuropathy),” Canadian Diabetes Association, http://www.diabetes.ca/diabetes-and-you/complications/nerve-damage-diabetic-peripheral-neuropathy (web page consulted December 16, 2014).

V. Bril et al. (2013) “Neuropathy,” Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Treatment of Diabetes in Canada, (Canadian Journal of Diabetes, vol. 37, pp. S518-S521), Canadian Diabetes Association.

Unité de médecine de jour métabolique de l’Hôtel-Dieu du CHUM. (2013). “Les complications chroniques,”Connaître son diabète pour mieux vivre, Montréal: Les Éditions Rogers limitée.

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