JDF Juvenile Diabetes Foundation International
Educational Publications


Diabetes and Nerve Disease

What is Diabetic Neuropathy?

The nervous system is the body s communication network, a complex linking system that carries messages from the control center--the brain and spinal cord--to the body s muscles, skin, blood vessels and organs. This system is central to everything we do. It allows us to feel pain, regulates our heartbeats, and tells us where our hands and feet are without looking at them.

People with diabetes are at an increased risk of damage to their nervous systems. In fact, nerve damage--or neuropathy--is one of the most common complications of diabetes. The impact of nerve damage can range from slight inconvenience to physical disabilities and even death.

Some Facts About Diabetic Neuropathy

Lowering Your Risk Factor
The development of neuropathy appears to be directly related to the duration of a person s diabetes and the level of control he or she keeps over blood sugar. The first line of defense against neuropathy is to bring blood sugar levels under the best control possible.

Once neuropathy has been diagnosed, the damage cannot be reversed. However, good control can slow the process, and possibly stop further damage. Ideally, good control should begin from the time a person is diagnosed with diabetes. Other factors that increase the risk of neuropathy are smoking and drinking alcohol.

Peripheral Neuropathy

Peripheral neuropathy affects the peripheral nervous systems, which links the legs, arms and outer trunk with the brain. This system of nerves allows you to feel sensations, telling you, for instance, to move your hand of you touch a hot iron. It allows you to walk, grasp objects, type a letter.

The most common type is called distal symmetrical polyneuropathy.

Distal Symmetrical Polyneuropathy

NOTE: Although distal symmetrical polyneuropathy does not cause much discomfort, the inability to feel pain can cause other serious problems. As the disease progresses, a minor injury to the foot can go unnoticed and become infected and ulcerated.

Mononeuropathy
Mononeuropathy attacks a single nerve. Symptoms very depending upon which nerve is affected, but mononeuropathy is usually acute and extremely painful. However, symptoms generally clear up in three months.

Cranial Mononeuropathy

Truncal Mononeuropathy

Proximal Motor Neuropathy

Autonomic Neuropathy

This type of neuropathy affects the autonomic nervous system, the nerves which control the whole range of bodily functions, including the action of the stomach, intestine, esophagus, bladder, genitals, sweat glands and even the heart. These are all nerves which work independently of conscious control. Symptoms vary considerably, depending on the organs affected.

Gastrointestinal Tract
The gastrointestinal tract is one continuous tube running from the mouth, to the stomach, to the intestines to the anus.

Sympathetic Nervous System

This system controls blood pressure, especially when a person stands up. Normally, nerves tell blood vessels to constrict when a person is standing so that a sufficient amount of blood will remain in the upper body and brain, instead of flowing with gravity to the feet. When the sympathetic nervous system fails, the blood vessels may not constrict quickly enough and too much blood will flow to the legs, depriving the brain of adequate circulation. The result--dizziness or fainting spells.

Sexual Dysfunction

See Your Doctor

Because neuropathies take so many different forms, it is essential that your physician be aware of your diabetes, eve if it s mild. It is far better to be overly cautious and mention even the least of symptoms you may have to your doctor. By making sure you know and understand the facts about neuropathy, you improve your chances or preventing some of the progressive and serious consequences.

Maintaining tight blood sugar control is the key to eliminating many of the symptoms of diabetic neuropathy. Other treatment options are available depending upon the specific type of neuropathy you may be experiencing. You should see your physician to obtain information about treatment.

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