Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentManagementFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Management
Frequently Asked Questions
Diabetic neuropathyis a common complication ofdiabetesthat develops in about 50% of people with the condition.Chronically high blood sugar levels associated with diabetes can cause nerve damage. This nerve damage can lead to burning pain,paresthesia(a feeling of pins and needles), weakness, and numbness (loss of sensation).
Diabetic neuropathy is a chronic, progressive condition. Fortunately, this condition can be managed with medication and lifestyle changes. The most effective medications are drugs that control your diabetes, which helps to slow the progression of this complication.
This article will look at how diabetic neuropathy is diagnosed and treated, including the most effective medication options and the drugs to avoid.
Types of Diabetic Neuropathy
There are four maintypesof diabetic neuropathy that may develop in relation to diabetes: peripheral, autonomic, proximal, and focal. Some people may experience just one type, while others may develop multiple types.
Peripheral Neuropathy
Peripheral neuropathyrefers to damage of nerves thatinnervate(supply with nerves) the parts of the body located outside the brain and spinal cord. Damage to this vast communication network can lead to symptoms of weakness, numbness, and pain in the hands and feet, although digestion, urination, and circulation may also be affected.
Autonomic Neuropathy
Digestion problems:Damage to the nerves that serve the gut can delay the emptying of the stomach (diabetic gastroparesis) and distort the control of intestinal motility (how waste is moved through the intestines). This can lead to a variety of symptoms such as diarrhea, constipation, intestinal distension (bloating), intestinal blockages, and abdominal pain.
Diabetes neuropathy may also affect the sensory nerves of the gut, and depending on which pathways are involved, your perception of being full or not full may be increased or reduced.
Cardiovascular problems:One of the most overlooked complications of diabetes iscardiovascular autonomic neuropathy(CAN), or damage to the autonomic nerve fibers that innervate the heart and blood vessels. Damage to the nerves that serve the heart can result in abnormalities in heart rate control and vascular dynamics, as well as symptoms of light-headedness, weakness, palpitations, and syncope (loss of consciousness due to a drop in blood pressure) that occurs when standing.
CAN also represents a significant cause of morbidity and mortality in diabetic patients because it is associated with a high risk of cardiac arrhythmias (irregular heartbeats) and sudden death due to the possibility of having a silent heart attack.
Sexual and bladder problems:Damage to the small nerves that serve the genitals in men and women can lead to a wide range of problems. Sexual problems in men with diabetes includeerectile dysfunctionand retrograde ejaculation (this occurs when semen enters the bladder instead of emerging through the penis during orgasm), whereas sexual problems in women include vaginal dryness, painful intercourse, decreased libido, and decreased or absent sexual response.
Damage to the small nerves that serve the bladder can lead to overactive bladder,urinary retention, urinary tract infections (UTIs), and poor control ofsphinctermuscles that surround the urethra.
Urinary Problems and Type 2 Diabetes
Proximal Neuropathy
Proximal neuropathy involves nerve damage to the hip, buttock, or thigh. It can cause severe pain and muscle shrinkage to the affected area.
Focal Neuropathy
Diabetic focal neuropathy, also calledmononeuropathy, involves damage to a single nerve, usually in the wrist or feet. It is less common than peripheral and autonomic neuropathy.Carpal tunnel syndromeandBell’s palsyare examples of focal neuropathy.
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Symptoms of Diabetic Neuropathy
Symptoms of diabetic neuropathy vary depending on the type of neuropathy that you have. Symptoms can range from mild to disabling.
Symptoms of peripheral neuropathy include:
Symptoms of autonomic neuropathy depend on the organ that is affected. Common symptoms include:
Proximal neuropathy can cause:
Focal neuropathy can cause tingling, pain, or numbness in the body area near the affected nerve, usually in a hand, wrist, or foot.
Slowing Charcot Foot Neuropathy
Causes of Diabetic Neuropathy
Although the exact cause of diabetic neuropathy is unknown, chronically high blood sugar levels have been shown to be toxic to nerves around the body.
Managing and Preventing Complications of Diabetes
Diagnosing Diabetic Neuropathy
If you have type 1 or type 2 diabetes, getting checked for damage to nerves in your hands, feet, and lower legs, is critical. Early diagnosis can relieve pain, protect your feet from small injuries before they become more serious, and motivate you to keep your blood sugar (glucose) within healthy limits.
Your assessment will start with a healthcare provider taking a thorough history and checking your vitals. Next, they will perform a physical exam.
A physical exam that emphasizes an assessment of your neurological function, including checking your muscle strength, reflexes, and ability to move, is the first step in assessing your nerve health.
What Is a Microfilament Exam?
Amicrofilamentexam is often used in the diagnosis of diabetic neuropathy. This exam uses nylon filaments (thin thread-like fibers) to help determine your ability to feel pressure.
A healthcare provider may also order some blood tests to rule out other causes of nerve damage. This may include:
Diabetic Neuropathy Medications
Diabetic nerve pain impacts 25% of all diabetics who are treated in the hospital, and an estimated 30%–40% of all people with diabetes. Unfortunately, many people with this condition do not report symptoms or do not seek care in a hospital setting. Therefore, these figures are likely huge underestimations.
Anti-Seizure Drugs
Antidepressants
Other Nerve Pain Medication
What Type of Nerve Pain Medication Is Right for Me?
Other Treatment Options
Topicals
Topical Creams for Neuropathy
Drugs to Be Avoided
Managing Diabetic Neuropathy
Lifestyle Changes
Nerve damage can reduce blood flow throughout the body and disrupt nerve signals, impacting sensation and motor function of the arms, legs, and major organs of the body resulting in a host of symptoms that may range from mild discomfort to severely debilitating.
The following lifestyle changes can help decrease your symptoms of diabetic neuropathy:
Prevention
The following steps may help you prevent diabetic neuropathy:
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Outlook
While diabetic neuropathy cannot be reversed, you can slow down its progression and improve your symptoms over time. Your general outlook ultimately depends on how well you control your diabetes.
Summary
Diabetic neuropathy is a late manifestation of uncontrolled or long-standing diabetes. Its main symptom is nerve pain. the anticonvulsant Lyrica, the antidepressant Cymbalta, and the opioid Nucynta are the only FDA-approved drugs in the treatment of diabetic neuropathy. However, other nerve pain medications, such as Neurontin, have been shown to reduce nerve pain symptoms and increase quality of life.
A Word From Verywell
Diabetic neuropathy is a highly treatable condition with oral medications, helping to relieve pain and restore function. However, the best way to limit symptoms and slow the progression of your condition is through strict management of your diabetes.
Frequently Asked QuestionsWhile diabetic neuropathy cannot be reversed, you can slow down its progression and improve your symptoms over time with a combination of lifestyle changes, medication, and blood sugar management.Cymbalta (duloxetine), Neurontin (gabapentin), and Lyrica (pregabalin) are the three most prescribed medications for neuropathy in diabetic patients.Cymbalta (duloxetine), Neurontin (gabapentin), and Lyrica (pregabalin) are the latest and only FDA-approved treatments for diabetic neuropathy.There is no consensus on the singular best medication for severe neuropathy. It’s likely that the most effective treatment will involve a combination of lifestyle changes, such as protecting your feet and avoiding injury, and the use of medication from multiple drug classes, starting with insulin or oral glucose-lowering medication to manage blood sugar levels and nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain.Cymbalta and Lyrica in conjunction with nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce pain and relieve inflammation are the best medicines for diabetic foot pain.
While diabetic neuropathy cannot be reversed, you can slow down its progression and improve your symptoms over time with a combination of lifestyle changes, medication, and blood sugar management.
Cymbalta (duloxetine), Neurontin (gabapentin), and Lyrica (pregabalin) are the three most prescribed medications for neuropathy in diabetic patients.
Cymbalta (duloxetine), Neurontin (gabapentin), and Lyrica (pregabalin) are the latest and only FDA-approved treatments for diabetic neuropathy.
There is no consensus on the singular best medication for severe neuropathy. It’s likely that the most effective treatment will involve a combination of lifestyle changes, such as protecting your feet and avoiding injury, and the use of medication from multiple drug classes, starting with insulin or oral glucose-lowering medication to manage blood sugar levels and nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain.
Cymbalta and Lyrica in conjunction with nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce pain and relieve inflammation are the best medicines for diabetic foot pain.
24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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