What It Is:

Diabetic neuropathy is a long-term complication of both Type 1 and Type 2 diabetes. It affects the nerves of the body. There is no cure for neuropathy.

Types of Neuropathy:

Autonomic neuropathy is damage caused to nerves that control the bladder, digestive tract and the reproductive organs.

Peripheral neuropathy affects nerves of the extremities, especially the feet and legs. Numbness and tingling, sensitivity to touch or muscle weakness are signs of neuropathy.

Symptoms include chronic pain, numbness and muscle wasting. Sores and ulcers are also a serious threat.

Causes of Neuropathy:

Neuropathy, or damage to the nervous system, can have many causes.

An injury or exposure to toxins can harm the nerves. Several chronic diseases can also affect the integrity of nerves over a long period of time. Parkinson's, multiple sclerosis and other conditions such as autoimmune diseases can cause damage to nerves. But diabetes is the biggest risk factor for neuropathy today.

Nerves Damaged by Abnormal Blood Glucose:

Neuropathy is a long-term complication of diabetes, which means it typically takes many years for neuropathy to develop. Nerve damage happens over time, due to prolonged exposure to the damaging affects of high blood glucose levels. The longer a person has diabetes, the higher the risk of developing neuropathy, especially if their disease is not controlled well.

Preventing or Reducing the Risk:

Good glucose control, a balanced eating plan and exercise can help fend off neuropathy. But sometimes, as in Type 1, no matter how tight the control, how balanced the diet or how much exercise a person gets, neuropathy can strike -- simply because of the sheer length of time the person has had diabetes. Also, many times, people who suffer from Type 2 diabetes don't even know they have the disease for many years. Much damage can occur during that time.

Treating Neuropathic Pain:

For mild to moderate pain, Tylenol or NSAIDS, such as Motrin or Aleve might be prescribed. Some of the more common medications for neuropathic pain include tricyclic antidepressants (TCAs) such as Elavil and Amitril. When TCAs are used to treat chronic pain, the dosage is much lower than for treating depression. Cymbalta (duloxetine hcl) is an SSRI, another kind of antidepressant medicine which shows success at treating both neuropathic pain and any underlying depression that also might exist.

Other Options for Treating Pain:

Some antiepileptic drugs (AEDs) also are showing success at relieving neuropathic pain. Neurontin and Lyrica are commonly prescribed AEDs. They work by reducing the frequency of pain signals that nerve cells send to the brain.

Stronger narcotic pain relievers are sometimes used for moderate to severe pain that does not respond to other medications.

How to Cope:

Occasionally neuropathy does not respond well to treatments for pain or it may get worse. For some people, it can lead to serious disability. If it hurts to walk, or if muscles are weak, it's hard to perform the activities of daily living. Try to pace yourself. Plan activities ahead of time, so you know what to expect. Don't try to do everything in one day. Ask for help or support from family and friends. Talking to a counselor or therapist can help with feelings of depression or anxiety.

Sources:

(2002, May). Diabetic Neuropathies: The Nerve Damage of Diabetes. Retrieved October 11, 2006, from National Diabetes Information Clearinghouse (NDIC) Web site: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/#treat

Al-Muhairi, MD, Amna, & Phillips, MD, FRCPC, Tania J. (2003, August). Diagnostic Dilemmas: Burning Feet due to Diabetic Neuropathy. Wounds - A Compendium of Clinical Research and Practice, 15, Retrieved October 11, 2006, from http://www.woundsresearch.com/article/1933.

(2006, September 29). Peripheral Neuropathy Fact Sheet. Retrieved October 12, 2006, from National Institute of Neurological Disorders and Stroke Web site: http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm