Nerves send messages to and from your brain about pain, temperature and touch. They tell your muscles when and how to move. They also control body systems that digest food and pass urine. About half of all people with diabetes have some form of nerve damage. It is more common in those who have had the disease for a number of years. Nerve damage from diabetes is called diabetic neuropathy (new-ROP-uh-thee). It can lead to many kinds of problems.

But if you keep your blood glucose levels on target, you may help prevent or delay nerve damage. There are treatments that can help as well.

What types of nerve damage can occur?

There are two common types of nerve damage. The first is sensorimotor (sen-so-re-MO-tor) neuropathy, also known as peripheral (puh-RIF-uh-rul) neuropathy. This can cause tingling, pain, numbness, or weakness in your feet and hands.

The second is called autonomic (aw-toh-NOM-ik) neuropathy. This type can lead to:

• digestive problems such as feeling full, nausea,
• vomiting, diarrhea, or constipation
• problems with how well your bladder works
• problems having sex
• dizziness or faintness
• loss of the typical warning signs of a heart attack
• loss of the warning signs of low blood glucose
• increased or decreased sweating
• changes in how your eyes react to light and dark

People with diabetes can also have what is called focal (FOH-kal) neuropathy. In this kind of nerve damage, a nerve or a group of nerves is affected, causing sudden weakness or pain. It can lead to double vision, a paralysis on one side of the face called Bell’s palsy, or pain in the front of the thigh or other parts of the body.

People with diabetes also are at risk for compressed nerves. Something in the body presses against a nerve preventing it from sending a signal. Carpal tunnel syndrome is a common cause of numbness and tingling in the fingers and can lead to muscle pain and weakness as well. Nerve damage can be hard to diagnose because its symptoms can be caused by other conditions. Symptoms can be very mild. Knowing the symptoms to look for and reporting them to your health care team can help. Make a list of your symptoms or use the checklists in this brochure. Your doctor will give you an exam and a number of tests to check for nerve damage.

What You Can Do If You Have Diabetic Neuropathy (Nerve Damage)

There’s a lot you can do to prevent or delay nerve damage. And, if you already have diabetic neuropathy (nerve damage), these steps can prevent or delay further damage and may lessen your symptoms.

Keep your blood glucose levels in your target range.

Meal planning, physical activity and medications, if needed, all can help you reach your target range. There are two ways to keep track of your blood glucose levels:

• Use a blood glucose meter to help you make decisions about day-to-day care
• Get an A1C test (a lab test) at least twice a year to find out your average blood glucose for the past 2 to 3 months

Checking your blood glucose levels will tell you whether your diabetes care plan is working or whether changes are needed.

• Report all possible signs of diabetic neuropathy.
• If you have problems, get treatment right away. Early treatment can help prevent more problems later on. For example, if you take care of a foot infection early, it can help prevent amputation.
• Take good care of your feet. Check your feet every day. If you no longer can feel pain in your feet, you might not notice a foot injury. Instead, use your eyes to look for problems. Use a mirror to see the bottoms of your feet. Use your hands to feel for hot or cold spots, bumps or dry skin. Look for sores, cuts or breaks in the skin. Also check for corns, calluses, blisters, red areas, swelling, ingrown toenails and toenail infections. If it’s hard for you to see or reach your feet, get help from a family member or foot doctor.
• Protect your feet. If your feet are dry, use a lotion on your skin but not between your toes. Wear shoes and socks that fit well and wear them all the time. Use warm water to wash your feet, and dry them carefully afterward.
• Get special shoes if needed. If you have foot problems, Medicare may pay for shoes. Ask your health care team about it.
• Be careful with exercising. Some physical activities are not safe for people with neuropathy. Talk with a diabetes clinical exercise expert who can guide you.