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Advice for people with diabetes and their families

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Diabetic neuropathy

Diabetic neuropathy is the name given to nerve damage caused by diabetes. It can affect different types of nerves in your body, including your sensory nerves, autonomic nerves and motor nerves. 

Nerves carry messages between the brain and every part of our bodies, making it possible to see, hear, feel and move. They also carry signals that we are not aware of to parts of the body such as the heart, altering the rate it beats at, and the lungs, so we can breathe.

Damage to the nerves can therefore cause serious problems in various parts of the body for people with type 1, type 2 or other types of diabetes. Common symptoms can include leg pain, muscle weakness or numbness and tingling in your feet or hands. 

What is diabetic neuropathy?

Neuropathy is one of the long-term complications of diabetes.

Over time, high blood glucose (sugar) levels can damage the small blood vessels which supply the nerves in your body. This prevents essential nutrients reaching the nerves. As a result, the nerve fibres can become damaged, and they may disappear. 

This can cause problems in many different parts of your body, depending on the type of nerve affected. Below, we explain the symptoms and the effects of damage to your sensory, autonomic or motor nerves. 

Sensory neuropathy

Sensory neuropathy affects the nerves that carry messages of touch, temperature, pain and other sensations from the skin, bones and muscles to the brain. It mainly affects the nerves in the feet and the legs, but people can also develop this type of neuropathy in their arms and hands.

Symptoms can include:

  • tingling and numbness
  • loss of ability to feel pain
  • loss of ability to detect changes in temperature
  • loss of coordination – when you lose your joint position sense
  • burning or shooting pains – these may be worse at night time.

The main danger of sensory neuropathy for someone with diabetes is loss of feeling in the feet, especially if you don’t realise that this has happened. This is dangerous because you may not notice minor injuries caused by:

  • walking around barefoot
  • sharp objects in shoes
  • friction from badly fitting shoes
  • burns from radiators of hot water bottles.

If ignored, minor injuries may develop into infections or ulcers. That's why it's important to look after your feet when you have diabetes.

 

People with diabetes are more likely to be admitted to hospital with a foot ulcer than with any other diabetes complication.

If you have neuropathy, you’re more at risk of developing Charcot foot. This is one of the serious foot complications caused by diabetes. We’ve got more information about what causes the complication, as well as how to treat and prevent it. 

Autonomic neuropathy

Autonomic neuropathy affects nerves that carry information to your organs and glands. They help to control some functions without you consciously directing them, such as stomach emptying, bowel control, heart beating and sexual organs working.

Damage to these nerves can result in:

  • gastroparesis – when food can’t move through the digestive system efficiently; symptoms of this can include bloating, constipation or diarrhoea
  • loss of bladder control, leading to incontinence
  • irregular heart beats
  • problems with sweating, either a reduced ability to sweat and intolerance to heat or sweating related to eating food (gustatory)
  • impotence (inability to keep an erection).

Motor neuropathy

Motor neuropathy affects the nerves which control movement. Damage to these nerves leads to weakness and wasting of the muscles that receive messages from the affected nerves. This can lead to problems such as:

  • muscle weakness, which could cause falls or problems with tasks such as fastening buttons.
  • muscle wasting, where muscle tissue is lost due to lack of activity
  • muscle twitching and cramps.

How is diabetic neuropathy treated?

There are many treatments available to relieve the symptoms caused by neuropathy. This may include medication for nausea and vomiting, painkillers for sensory neuropathy or treatment to help with erectile dysfunction.

Keeping your blood sugar levels within your target range can also help to improve the symptoms of neuropathy and reduce the progression of the nerve damage.

Steps you can take to avoid diabetic neuropathy

  • keep your blood sugar levels within your target range
  • have your feet checked at least once a year.
  • tell your diabetes healthcare team if you think you’re developing any signs of neuropathy
  • if you think you’ve lost sensation in your feet, protect them from injury and check them every day
  • and talk to your diabetes healthcare team.
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