Johns Hopkins
Help in Preventing Nerve Disease

Nerve disease in people who have diabetes is called diabetic neuropathy. About 50 percent of people who have diabetes will develop some type of neuropathy. People who have had diabetes for a long time and those who have poor glycemic control are more at risk for neuropathy.

What is neuropathy?

Diabetes can damage the nerves in several different ways, but the nerve damage is almost always related to high blood levels of glucose. Since nerves run throughout our bodies, there are several different types of neuropathy.

The 2 most common types of neuropathy are peripheral and autonomic. The nerves making up the peripheral nervous system serve to connect the central nervous system (the brain and the spinal cord) to the limbs and organs. Peripheral damage, which is the most common type of nerve damage in people with diabetes, causes the symptoms of peripheral neuropathy, including pain, numbness, weakness, or tingling in the hands or feet.

The autonomic (or involuntary) nervous system operates mostly below the level of consciousness and acts to control such reflexive functions of the body as heart rate, digestion, respiratory rate, salivation, sweating, pupillary dilation, bladder control, and sexual function. Damage to these nerves, called autonomic neuropathy, affects the nerves that control these involuntary functions.

Problems from Neuropathy

Diabetic neuropathy is the culprit in 50 percent to 75 percent of non-traumatic amputations (that is, those not caused by injury) in the general population. Trouble can start with a small cut on a toe--and because that toe is numb from a neuropathy, the person with diabetes can’t feel the cut. Next, the cut becomes infected and that infection enters the bloodstream. And just like that, a little cut becomes a huge problem.

People with neuropathy might also have problems with such conditions as diarrhea, constipation, nausea, vomiting, dizziness, low blood pressure, and too-early feelings of fullness, as well as sexual problems such as erectile dysfunction and vaginal dryness.

Preventing Neuropathy

The best thing you can do to prevent neuropathy is to control your glucose levels. Knowing your A1C level and working to get it below 7 percent is important. Research has shown that good glycemic control can reduce neuropathy by up to 60 percent. Testing your glucose levels at home can help you to make daily decisions as well as identify any problem areas that might need some work.

And Don’t Forget: Inspect Your Feet Each Day

It is also imperative to take good care of your feet and to check them every day for cuts, blisters, or sores. If you have problems looking at the bottoms of your feet, use a mirror on the floor to see. And if you see or feel anything unusual, call your doctor or see a podiatrist.

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