Diabetic neuropathy
Diabetic neuropathyDiabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar(glucose) can injure nerves throughout your body. Diabetic neuropathy most often damages nerves inyour legs and feet. Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbnessin your legs and feet to problems with your digestive system, urinary tract, blood vessels andheart. Some people have mild symptoms. But for others, diabetic neuropathy can be quite painful anddisabling. Diabetic neuropathy is a common and serious complication of diabetes. But you can often preventdiabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle. Symptoms Diabetic neuropathyThere are four main types of diabetic neuropathy. You can have one or more than one type ofneuropathy. Your symptoms will depend on the type you have and which nerves are affected. Usually,symptoms develop gradually. You may not notice anything wrong until considerable nerve damage hasoccurred. Peripheral neuropathyPeripheralneuropathy is the most common type of diabetic neuropathy. It affects the feet and legsfirst, followed by the hands and arms. Signs and symptoms of peripheral neuropathy are often worseat night, and may include: Autonomic neuropathyThe autonomic nervous system controls your heart, bladder, stomach, intestines, sex organs andeyes. Diabetes can affect nerves in any of these areas, possibly causing: Radiculoplexus neuropathy (diabetic amyotrophy)Radiculoplexus neuropathy affects nerves in the thighs, hips, buttocks or legs. It’s more common inpeople with type 2 diabetes and older adults. Other names for this type are diabetic amyotrophy,femoral neuropathy or proximal neuropathy. Symptoms are usually on one side of the body, but sometimes may spread to the other side. You mayhave: MononeuropathyMononeuropathy, or focal neuropathy, is damage to a specific nerve in the face, middle of the body(torso) or leg. It’s most common in older adults. Mononeuropathy often strikes suddenly and cancause severe pain. However, it usually doesn’t cause any long-term problems. Symptoms usually go away without treatment over a few weeks or months. Your specific signs andsymptoms depend on which nerve is involved. You may have pain in the: When to see a doctor?Call your doctor for an appointment if you have: Causes Diabetic neuropathyDamage to nerves and blood vesselsThe exact cause likely differs for each type of neuropathy. Researchers think that over time,uncontrolled high blood sugar damages nerves and interferes with their ability to send signals,leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels(capillaries) that supply the nerves with oxygen and nutrients. However, a combination of factors may lead to nerve damage, including: Inflammation in the nerves caused by an autoimmune response. The immune system mistakes nerves asforeign and attacks them. Genetic factors unrelated to diabetes may make some people more likely to develop nerve damage. Smoking and alcohol abuse damage both nerves and blood vessels and significantly increase the riskof infection. Risk factors Diabetic neuropathyAnyone who has diabetes can develop neuropathy, but these risk factors make you more likely to getnerve damage: Poor blood sugar control.Uncontrolled blood sugar puts you at risk of every diabetes complication, including nerve damage. Diabetes history.Your risk of diabetic neuropathy increases the longer you have diabetes, especially if your bloodsugar isn’t well-controlled. Kidney disease.Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nervedamage. Being overweight.Having a body mass index (BMI) greater than 24 may increase your risk of diabetic neuropathy. Smoking.Smoking narrows and hardens your arteries, reducing blood flow to your legs and feet. This makes itmore difficult for wounds to heal and damages the peripheral nerves. Complications Diabetic neuropathyDiabetic neuropathy can cause a number of serious complications, including: Loss of a toe, foot or leg. Nerve damage can make you lose feeling in your feet. Foot sores and cuts may silently become severely infected or turn into ulcers. Even minor foot sores that don’t heal can turn into ulcers.In severe cases, infection can spread to the bone, and ulcers can lead to tissue death (gangrene).Removal (amputation) of a toe, foot or even the lower leg may be necessary. Joint damage.Nerve damage can cause a joint to deteriorate, causing a condition called Charcot joint. Thisusually occurs in the small joints in the feet. Symptoms include loss of sensation and jointswelling, instability and sometimes joint deformity. Prompt treatment can help you heal and preventfurther joint damage. Urinary tract infections and urinary incontinence.If the nerves that control your bladder are damaged, you may be unable to fully empty your bladder.Bacteria can build up in the bladder and kidneys, causing urinary tract infections. Nerve damagecan also affect your ability to feel when you need to urinate or to control the muscles thatrelease urine, leading to leakage (incontinence). Hypoglycemia unawareness.Low blood sugar (below 70 milligrams per deciliter, or mg/dL) normally causes shakiness, sweatingand a fast heartbeat. But if you have autonomic neuropathy, you may not notice these warning signs.Sharp drops in blood pressure. Damage to the nerves that control blood flow can affect your body’sability to adjust blood pressure. This can cause a sharp drop in pressure when you stand aftersitting (orthostatic hypotension), which may lead to dizziness and fainting. Digestive problems.If nerve damage strikes your digestive tract, you can have constipation or diarrhea, or bouts ofboth. Diabetes-related nerve damage can lead to gastroparesis, a condition in which the stomachempties too slowly or not at all. This can interfere with digestion and severely affect blood sugarlevels and nutrition. Signs and symptoms include nausea, vomiting and bloating. Sexual dysfunction.Autonomic neuropathy often damages the nerves that affect the sex organs. Men may experienceerectile dysfunction. Women may have difficulty with lubrication and arousal. Increased or decreased sweating.Nerve damage can disrupt how your sweat glands work and make it difficult for your body to controlits temperature properly. Some people with autonomic neuropathy have excessive sweating,particularly at night or while eating. Too little or no sweating at all (anhidrosis) can be life-threatening. Prevention Diabetic neuropathyYou can prevent or delay diabetic neuropathy and its complications by keeping tight control of yourblood sugar and taking good
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