Your Nerves

After many years of living with diabetes, some people develop a nerve disease known as diabetic neuropathy. This disease affects peripheral nerves, which serve the muscles, skin and inner organs.

What is ‘neuropathy’?

You may hear the term ‘neuropathy’. This is another potential complication of poorly controlled diabetes. ‘Neuropathy’ simply means disease of the nerves.

Which nerves are affected?

Nerves need blood to survive, so damage to small blood vessels that supply the nerves leaves them with too little blood. Any nerve in the body can be affected, but there are some typical symptoms that you might notice. These are described below.

Symptoms of neuropathy

Often the first sign that nerves are affected is a patch of numbness or tingling in the toes or feet. The skin may be tender. Some people experience pain, whereas others find themselves unable to feel pain or temperature. This can be extremely dangerous, since pain and temperature act as alarm bells to warn us of potential danger. Some people say that numbness in the feet makes it feel like they are walking on cotton wool. If you have longstanding diabetes, you might notice muscle weakness.

Effects on specific organs

Widespread damage to nerves can affect the intestinal system, causing diarrhoea. Some people experience a full feeling in the stomach, or nausea. You may notice dizziness if you stand up quickly, and it is best to get up slowly, and with assistance. Damage to nerves in the pelvis can lead to bladder problems and men may have difficulty getting an erection. Because your ability to detect pain is reduced, your feet need special attention. Foot problems are very common in people with diabetes, so this topic is covered in detail in the section on ‘Your Feet’.

Preventing neuropathy

Good control of your blood sugar and diabetic treatment will slow down or prevent neuropathy, and hence reduce the likelihood of your suffering the symptoms. This has been proven in many large research studies.

Treatment of symptoms

If you are in pain, trying a painkiller suggested by your doctor is a good start. However, neuropathic pain can be difficult to treat with common painkillers. We now know that drugs normally used to combat depression can be excellent painkillers. For some people the antidepressant effect is also a bonus, as learning to deal with the problems associated with diabetes can make you feel low at times. The specific organ complications need addressing on an individual basis. As these can be difficult to treat, your GP may refer you to a neurologist – the specialist who deals with nerve problems.

APP/KOL/AC 22/02/07