Extension Rural Health & Nutrition

Neuropathy: Increasing Awareness of Nervous System-Related Complications from Diabetes

Posted on by mbales
Talking with a healthcare provider can help people with diabetes better understand their risk for developing neuropathy and other complications from diabetes. Photo credit: RHN Team Picture Bank

The Nervous System

The nervous system is responsible for sending messages throughout the body via electrical signals. These electrical signals instruct our bodies to perform various tasks, such as walking, talking, thinking, and digesting food.

The brain and spinal cord make up the central nervous system. The nervous system is comprised of nerve cells known as neurons. Nerves that branch off from the spinal cord comprise the peripheral nervous system, and these nerves play essential roles in regulating voluntary movements, such as raising an arm and involuntary movements like breathing. When abnormalities arise in the nervous system, our bodies may exhibit various symptoms that should not be ignored.

High Glucose and the Nervous System

For people living with diabetes, it is essential to maintain good blood glucose management to reduce the risk of nervous system-related complications. Exposure to chronically high blood glucose levels can harm nerves throughout the body. Some other risk factors for developing nerve damage from diabetes include being 40 years of age or older, being overweight or obese, having high blood pressure or high cholesterol, and having diabetes for many years. Working with a healthcare provider to develop a management plan can help people with diabetes prevent or delay complications associated with this condition.

What is Neuropathy?

The term neuropathy encompasses several conditions that can affect nerves throughout the peripheral nervous system. Neuropathy can be classified into various conditions based on symptoms and the specific nerves involved. People living with diabetes are at risk for several different types of neuropathies.

Types of Diabetes-Related Neuropathies

Peripheral Neuropathy

Peripheral neuropathy refers to a range of conditions that involve damage to the peripheral nervous system. The peripheral nervous system controls functions such as:

  • movement
  • sensation
  • organ activity

Risk factors for developing peripheral neuropathy in people with diabetes include:

  • age
  • poor glucose control
  • obesity
  • having hypertension
  • having peripheral vascular disease
  • smoking
  • excessive alcohol intake
  • abnormal cholesterol levels
  • having diabetes for many years

Some of the symptoms of peripheral neuropathy include mild to severe numbness, tingling, aching, and burning sensations in the hands and feet. Some individuals may experience weakness in their limbs and/or hyperalgesia, which is an increased sensitivity to pain. Allodynia is another symptom in which individuals have an increased sensitivity to pain, where non-painful stimuli such as light touch, pressure, or temperature changes trigger intense pain.

Peripheral neuropathy can put people with diabetes at greater risk for experiencing:

  • pain
  • infections in the feet
  • amputations
  • falls due to dizziness
  • dehydration
  • decrease in quality of life

Autonomic Neuropathy

Autonomic neuropathy affects the nerves that support the function of internal organs. Over time, exposure to high glucose levels and/or high levels of fat, like triglycerides, in the blood can damage these nerves and the small blood vessels that supply them with nutrients. The damage to these nerves can lead to the development of autonomic neuropathy. This type of neuropathy can potentially cause problems with a person’s:

  • heart rate and blood pressure
  • digestion
  • bladder
  • sex organs
  • sweat glands
  • eyes
  • ability to sense hypoglycemia, or low blood glucose

There are varying symptoms that occur with autonomic neuropathy, depending upon which organ system is affected. For example, one particular condition linked to nerve damage that can affect digestion is gastroparesis, characterized by delayed gastric emptying. Refer to Gastroparesis on the Rural Health and Nutrition Blog for more information on this condition. Healthcare professionals can perform exams and tests to help determine if a person’s symptoms are attributed to autonomic neuropathy. Treatment plans vary depending on which organ system is affected.

Focal Neuropathy

Focal neuropathy refers to damage to a single nerve and is less common than peripheral and autonomic neuropathies. This type of neuropathy typically affects one of the hands or legs, head, or torso. Having diabetes can put people at risk for developing focal neuropathies like entrapments and cranial neuropathies, which can cause different symptoms depending on which nerves are involved.

Nerve entrapment, also known as nerve compression, occurs when a nerve is damaged due to pressure or swelling of surrounding tissues. One common type of nerve entrapment is carpal tunnel syndrome, which affects the median nerve in the wrist and can cause:

  • pain
  • numbness
  • tingling in the thumb, index finger, and middle finger
  • changes in the grip strength of the hand

Cranial neuropathies affect the cranial nerves in the head and neck. Symptoms can include:

  • double vision
  • blurry vision
  • aching behind one eye
  • problems focusing the eyes
  • Bell’s palsy, which is paralysis on one side of the face

Only healthcare providers can diagnose and treat focal neuropathy by assessing symptoms through medical examination and performing relevant tests.

Proximal Neuropathy

Proximal neuropathy is a rare condition, but those affected by it can experience disabling pain from nerve damage in the hip, buttock, or thigh. This type of nerve damage typically:

  • affects one side of the body
  • can cause sudden or severe pain in the hip, buttock, or thigh
  • causes weakness in the legs, making it difficult to stand from a sitting position

Like peripheral, autonomic, and focal neuropathies, proximal neuropathy can develop due to exposing nerves to high levels of glucose and/or fat, like triglycerides, in the blood over time. With good glucose management and treatment from a healthcare professional, symptoms can gradually improve over months or years, but the rate of improvement varies.  

Reducing the Risk of Developing Diabetes-Related Neuropathies

Preventive actions can be taken to help reduce the risk of developing diabetes-related neuropathies. The first action is to keep blood glucose levels within a target range as much as possible. It is essential for people with diabetes to work with a healthcare professional to determine their target ranges for blood glucose and hemoglobin A1C. Additionally, key actions for diabetes management include eating a balanced diet with healthy food choices, staying active, taking medications as prescribed, and not smoking or vaping. If someone is experiencing symptoms of neuropathy, they should not ignore them. Instead, they should discuss the symptoms with their healthcare team immediately so a treatment plan can be determined. It is also crucial for individuals with diabetes to inspect their feet daily for signs of ulcers, wounds, or broken skin. Injuries to the feet can be serious for people with diabetes, as they may not notice redness, swelling, or pain due to numbness in their feet.  For more resources on proper foot care and diabetes self-management, go to Clemson Extension’s Home and Garden Information Center. Factsheets and blog posts related to foot care and other areas of diabetes management include:

While diabetes puts people at risk for developing complications like neuropathy, following diabetes self-management practices can help reduce these risks. If you or someone you know is struggling with diabetes management, consider joining a Health Extension for Diabetes support program in your local area to receive support and learn about managing diabetes.

References:

Authors:

  • Kathryn Flynn, Rural Health and Nutrition, Oconee and Pickens Counties
  • Phoebe Covode, UPIC Intern, Rural Health and Nutrition

Reviewed By:

  • Ellie Lane, Extension Associate, Rural Health and Nutrition
  • Melissa Bales, Extension Associate, Rural Health and Nutrition

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