Diabetic Neuropathy

Diabetic neuropathy, a nerve disorder caused by diabetes, is characterized by a loss or reduction of sensation in the feet, and in some cases the hands, and pain and weakness in the feet.

The symptoms of diabetic neuropathy, which vary among patients, are often slight at first. In fact, some mild cases may go unnoticed for a long time. The first sign of the disease is usually numbness, pain, or tingling in the hands, feet, or legs. Occasionally, diabetic neuropathy can flare up suddenly, causing weakness, burning sensations in the extremities, and weight loss.

Nerve damage caused by diabetes generally occurs over a period of years and may lead to problems with internal organs including the digestive tract, heart, and sexual organs. These problems can then tend to cause indigestion, diarrhea or constipation, dizziness, bladder infections, and impotence.

The loss of sensation in the feet is important as it may increase the possibility of injuries of which the patient is not aware. These foot injuries can develop into ulcers or lesions that can become infected. In some cases, ulcers may not heal and amputation may be required.

The goal of treatment for diabetic neuropathy is to relieve discomfort and prevent further tissue damage. The first step is to bring blood sugar levels under control by diet and medication.

Another important part of treatment involves taking special care of the feet. Analgesics, low doses of antidepressants, and some anticonvulsant medications may be prescribed for relief of pain, burning, or tingling.

Another treatment option for pain is transcutaneous electronic nerve stimulation (TENS) -- an electronic unit that uses a small electrical current to control pain. Some patients may find that walking regularly, taking warm baths, or using elastic stockings may help relieve leg pain.

Prognosis for diabetic neuropathy depends largely on management of diabetes, the underlying condition. Treating the diabetes may halt progression and improve symptoms of the neuropathy, but recovery is slow. The painful sensations of diabetic neuropathy may become severe enough to cause depression in some patients.

Information provided by the
National Institute of Neurological Disorders and Stroke,
National Institutes of Health

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.