Talking With Your Doctor About Diabetic Neuropathy

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Diabetes affects nearly 26 million people in the United States. Nerve damage, known as diabetic neuropathy, is one of the most common complications experienced by long-term diabetics. It affects up to 70% of those with diabetes to some degree. 

Neuropathy is caused by higher than normal blood sugar (glucose) levels. With time, excess blood glucose can damage the walls of the tiny blood vessels that support your nerves. Blood vessels and nerves can begin to degenerate, causing nerves to stop functioning normally. You can develop neuropathy at any time, but the complication is most prevalent in people who’ve had diabetes for at least 25 years. 

Your diabetes doctor—an endocrinologist—should monitor you for signs of nerve damage at every checkup. And it’s important to keep an open dialogue with your doctor about the possibility of nerve damage. Knowing the facts about diabetic neuropathy will help you have a good conversation with your doctor.

Neuropathy at a Glance

Two common types of neuropathy caused by diabetes include:

Autonomic neuropathy: This type of neuropathy affects the nerves that control your digestive system, urinary tract, sexual organs, heart and blood vessels, sweat glands, and eyes. Autonomic neuropathy can cause urinary tract infections, erectile dysfunction, diarrhea, constipation, vomiting, and bloating. 

Peripheral neuropathy: This form of neuropathy, which is the most common, results from damage to the nerves outside the brain and spinal cord. It can cause pain, numbness, tingling or weakness in the hands and feet. 

If you’ve been diagnosed with diabetes, be proactive. Here are topics to bring up with your doctor that can help you take steps to prevent or manage diabetic neuropathy and prevent future problems. 

Talk About Your Symptoms 

Watch out for symptoms of diabetic neuropathy and report any you experience to your doctor right away. The most common symptoms include: 

  • Burning, stabbing or shooting pains in your feet
  • Feet that feel numb, to the point where you may not be able to feel the pain of a blister
  • Feeling unsteady on your feet when you stand or walk
  • Weakness 
  • Hands and feet that feel very cold or hot
  • Not being able to feel your feet when you’re walking
  • Tingling or a “pins and needles” feeling in your feet
  • Increased sensitivity, such as pain when even just the bed sheets touch your feet
  • Diarrhea or constipation
  • Indigestion, nausea or vomiting
  • Erectile dysfunction (men) and vaginal dryness (women)

Your doctor can perform sensitivity tests, such as nerve conduction studies, that detect the speed with which your nerves send messages, and electromyography, which checks how well your nerves and muscles are working together. Getting treated early for neuropathy can stop your nerves from further degenerating and reduce pain.

Talk About Your Treatment Plan

The best way to prevent or delay diabetic neuropathy is keep your blood glucose levels in your target range by managing your diet, exercising regularly, and using a blood glucose meter daily. Also, ask your doctor about getting an A1c blood test at least twice a year. An A1c test provides your average blood glucose for the past 2 or 3 months. 

To better manage or even prevent diabetic neuropathy, make it your goal to maintain an A1c of less than 7%. If your A1c is consistently off the mark, ask your doctor what changes you should make to your diabetes care plan to better manage your condition, protect your nerves, and lessen neuropathy symptoms. 

If you experience the pain, burning, tingling or numbness of diabetic neuropathy, talk with your doctor about medication and pain management treatment options to manage these symptoms. 

Talk About Your Foot Care

A lack of sensation in your feet from neuropathy can reduce your ability to feel pain, heat and cold temperatures. Inspect your feet regularly and ask your doctor to check your feet at each office visit to check for sores, blisters and numbness. Take your shoes and socks off at the start of each doctor’s visit as a reminder. People with diabetic neuropathy are prone to foot wounds that can become infected, which is why proper foot care is so important.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Apr 13

  1. Autonomic neuropathy. American Diabetes Association.

  2. Diabetic Neuropathies: The Nerve Damage of Diabetes. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases.

  3. Diabetic Neuropathy. American Association of Neuromuscular & Electrodiagnostic Medicine.

  4. Diabetic Neuropathy (Nerve Damage) - An Update. Joslin Diabetes Center.

  5. National Diabetes Fact Sheet, 2011. Centers for Disease Control and Prevention.

  6. Neuropathy (Nerve Damage). American Diabetes Association.

  7. Peripheral Neuropathy. American Diabetes Association.

  8. Steps to Prevent or Delay nerve damage. American Diabetes Association.

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