Diabetes and Peripheral Neuropathy: What You Need to Know

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Everyone has had the sensation of numbness or “pins and needles” in an arm or leg—perhaps after sitting or sleeping the wrong way, which causes the limb to “fall asleep” temporarily. Now imagine if that sensation never went away. That’s what millions of people experience every day, due to peripheral neuropathy.

Peripheral neuropathy occurs when the nerves connecting the brain and spinal cord to the legs, feet, arms, or hands are damaged. As a result, nerves transmit signals poorly or activate spontaneously. Depending on which nerves are damaged and how badly, you may experience pain or numbness, a burning or tingling sensation, increased sensitivity to touch, muscle weakness, or other symptoms in the extremities connected to the affected nerves.

The most common risk factor is diabetes, especially in those who have had the disease for more than 25 years or have poorly controlled blood sugar. People with prediabetes, in which blood sugar is only modestly elevated, also appear to be at elevated risk.

Here are some basics about the condition and how, while usually not curable, it can be made easier to live with.

How is it diagnosed?
If you are experiencing symptoms of peripheral neuropathy, your healthcare provider can confirm the diagnosis with quick neurological tests of your ability to detect pain, light touch, and vibration on the skin, as well as evaluate your reflexes and muscle strength. If the results suggest you have peripheral neuropathy, additional testing may be done to determine the type of neuropathy. There are more than 100, with varying causes, symptoms, and types of nerve damage.

How is it treated?
Treatment depends on the cause and severity of the neuropathy. If caused by a nutritional deficiency, for example, correcting the deficiency often alleviates the neuropathy; if it is a side effect of medication, switching to a different drug should help. But with some causes the damage is likely to be permanent.

For instance, if the nerve damage is related to diabetes or another underlying disease, treating or at least controlling the disease may only prevent the worsening of neuropathy. In that case, there are treatments that target the symptoms, such as pain and tingling. Over-the-counter anti-inflammatory pain relievers can help mild cases. Various prescription medications may also be used, including several antidepressant and antiseizure drugs. If your pain is limited to one area, your healthcare provider may recommend a topical treatment, such as a patch containing capsaicin (found in hot peppers) or lidocaine (an anesthetic).

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