Diabetic neuropathy: A family of nerve disorders caused by diabetes. Diabetic neuropathies cause numbness and sometimes pain and weakness in the hands, arms, feet, and legs. Neurologic problems in diabetes may occur in every organ system, including the digestive tract, heart, and genitalia. People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater is the risk.
About half odf diabetics have some form of neuropathy, but not all with neuropathy have symptoms. The highest rates of neuropathy are among people who have had the disease for at least 25 years. Diabetic neuropathy is more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40.
Diabetic neuropathies are classified as peripheral, autonomic, proximal, and focal. Peripheral neuropathy causes pain or loss of feeling in the toes, feet, legs, hands, and arms. Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration and can also affect the nerves that serve the heart and control blood pressure. Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs. Focal neuropathy results in the sudden weakness of one nerve, or a group of nerves, causing muscle weakness or pain. Any nerve in the body may be affected.
The blood glucose levels should be brought within the normal range to prevent further nerve damage. Although symptoms may get worse when blood glucose is first brought under control, maintaining lower blood glucose levels over times helps lessen neuropathic symptoms and prevent further problems. Good foot care is mandatory. Analgesics, low doses of antidepressants, and some anticonvulsant medications may be prescribed for relief of pain, burning, or tingling. Some patients may find that walking regularly, taking warm baths, or using elastic stockings may help relieve leg pain.