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Advice for people with diabetes and their families

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Peripheral neuropathy (nerve damage)

Peripheral neuropathy is when diabetes causes damage to your nerves, particularly in your hands and feet. It can affect different types of nerves in your body, including in your feet, organs and muscles

Nerves carry messages between the brain and every part of our bodies so that we can see, hear, feel and move. They also carry signals to parts of the body such as the heart, making it beat at different speeds, 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.  

Causes of peripheral neuropathy 

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

Over time, high blood glucose (sugar) levels can damage the small blood vessels that supply the nerves in your body. This stops 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. 

Neuropathy in feet

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. 

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, for example if you step on something sharp while barefoot or get a blister from badly-fitting shoes.  

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. 

Symptoms of sensory neuropathy can include: 

  • tingling and numbness 
  • loss of ability to feel pain 
  • loss of ability to feel changes in temperature 
  • loss of coordination – when you can’t feel the position of your joints 
  • burning or shooting pains – these may be worse at night time. 

People with diabetes are more likely to be admitted to hospital with a foot ulcer than with any other diabetes complication. We’ve got lots of information on taking care of your feet when you have diabetes. 

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 Charcot foot, 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 thinking about them, like your stomach emptying, how regularly your heart beats, and how your sexual organs work. 

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 (not being able to control when you pee) 
  • irregular heart beats 
  • problems with sweating - either not being able to sweat properly and intolerance to heat, or sweating related to eating food (gustatory) 
  • impotence (inability to keep an erection). 

"When I was diagnosed, the reality of what gastroparesis actually is hit me. I had a really nice nurse at the time and she said, ‘you’ve got this complication, it will change your life, but you can’t let it ruin your life.’"

Karen developed gastroparesis when she was 25. Read her story to find out how she has learned to manage it over the year. 

Motor neuropathy

Motor neuropathy affects the nerves that 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 muscles weakness, which could cause falls or problems with doing tasks like fastening buttons, and muscles wasting where muscle tissues is lost because it’s less active. It can also lead to muscle twitching and cramps.

Treatment for peripheral neuropathy 

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 peripheral neuropathy

You can avoid peripheral neuropathy by keeping your blood sugar levels within your target range, which will help protect the blood vessels that supply your nerves. You should also check your feet every day and have your feet checked by a healthcare professional once a year. This is particularly important if you think you’ve lost the feeling in your feet. Speak to your diabetes healthcare team for advice if you think you’re developing any signs of neuropathy,  

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