Diabetic Neuropathy

An umbrella term for nerve disorders caused by prolonged exposure to high blood glucose levels. Peripheral neuropathy, the most common form of diabetic neuropathy, can cause pain or loss of feeling in the toes, feet, legs, hands, and arms. Autonomic neuropathy can affect digestion, bowel and bladder function, sexual functioning, heart rate, and blood pressure. It can also cause hypoglycemia unawareness, in which the person loses the ability to experience symptoms of low blood sugar. Proximal neuropathy can cause pain in the thighs, hips, or buttocks and may cause leg weakness. Focal neuropathy can affect any nerve or group of nerves throughout the body, resulting in muscle weakness or pain. An estimated 60 to 70 percent of people with diabetes have some form of neuropathy.

Peripheral neuropathy most commonly affects the feet and legs. Symptoms may include numbness or insensitivity to pain or temperature, a tingling, burning, or prickling sensation, sharp pains or cramps, extreme sensitivity to touch, and loss of balance or coordination.

There is strong evidence that careful long-term blood glucose control can help prevent or delay the progression of diabetic neuropathy and may even ease existing symptoms. People can alleviate mild neuropathic pain using non-steroidal anti-inflammatory drugs (NSAIDs). To treat more chronic and severe pain, doctors may prescribe tricyclic antidepressants such as amitriptyline; other types of antidepressants such as duloxetine hydrochloride or venlafaxine; anticonvulsant medications such as gabapentin, pregabalin, topiramate, and carbamazepine; and the antiarrythmic medication mexiletine.

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