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Integrated Pain Management


A Bad Pair - Neuropathy and Diabetes

Neuropathy and diabetes are closely linked, as diabetic neuropathy is a specific kind of nerve damage that occurs in individuals with diabetes. Symptoms of this condition can vary depending on which nerves are affected. They may include pain and numbness in the legs and feet, as well as issues related to the digestive system, urinary tract, blood vessels, and heart. The severity of symptoms in diabetic neuropathy can range from mild to more significant manifestations.

Neuropathy and Diabetes

Diabetic neuropathy is a serious diabetic complication that may affect as many as 50% of people with diabetes. But you can often prevent diabetic neuropathy or slow its progress with consistent blood sugar management and a healthy lifestyle.

Risk factors

Anyone who has diabetes can develop neuropathy. However, certain risk factors associated with Neuropathy and diabetes make it more likely to experience nerve damage.

Poor blood sugar control. Uncontrolled blood sugar puts you at risk of every diabetes complication, including nerve damage.

Diabetes history. Your risk of diabetic neuropathy increases the longer you have diabetes

Kidney disease. Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nerve damage.

Smoking. Smoking narrows and hardens your arteries, reducing blood flow to your legs and feet. This makes it more difficult for wounds to heal and damages the peripheral nerves.


There are four main types of diabetic neuropathy. You can have one or more types of neuropathy and symptoms will depend on the type you have and which nerves are affected. Usually, symptoms develop gradually. You may not notice anything is wrong until considerable nerve damage has occurred. The following are the four main types of neuropathy as well as a brief explanation of each one: 

1. Peripheral neuropathy

This type of neuropathy may also be called distal symmetric peripheral neuropathy. It’s the most common type of diabetic neuropathy. It affects the feet and legs first, followed by the hands and arms.

Signs and symptoms of peripheral neuropathy are often worse at night, and may include:

> Numbness or reduced ability to feel pain or temperature changes

> Tingling or burning sensation

> Sharp pains or cramps

> Increased sensitivity to touch — for some people, even a bedsheet’s weight can be painful

> Serious foot problems, such as ulcers, infections, and bone and joint pain

2. Autonomic neuropathy

The autonomic nervous system controls your heart, bladder, stomach, intestines, sex organs, and eyes.

Diabetes can affect nerves in any of these areas, possibly causing:

> A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)

> Bladder or bowel problems

> Slow stomach emptying (gastroparesis), causing nausea, vomiting, and loss of appetite

> Changes in the way your eyes adjust from light to dark

> Decreased sexual response

3. Proximal neuropathy (diabetic polyradiculopathy)

This type of neuropathy — also called diabetic amyotrophy — often affects nerves in the thighs, hips, buttocks, or legs. It can also affect the abdominal and chest area. Symptoms are usually on one side of the body but may spread to the other side.

You may have:

> Severe pain in a hip and thigh or buttock

> Eventual weak and shrinking thigh muscles

> Difficulty rising from a sitting position

> Severe stomach pain

4. Mononeuropathy (focal neuropathy)

There are two types of mononeuropathy — cranial and peripheral.

Mononeuropathy refers to damage to a specific nerve. Mononeuropathy may also lead to:

> Difficulty focusing or double vision

> Aching behind one eye

> Paralysis on one side of your face (Bell’s palsy)

> Numbness or tingling in your hand or fingers, except your pinkie (little finger)

> Weakness in your hand that may cause you to drop things

When to see a doctor

Call your doctor for an appointment if you have:

>A cut or sore on your foot that is infected or won’t heal

> Burning, tingling, weakness, or pain in your hands or feet that interferes with daily activities or sleep

> Changes in digestion, urination, or sexual function

> Dizziness and fainting

It is recommended that screening for diabetic neuropathy begin immediately after someone is diagnosed with type 2 diabetes and five years after diagnosis for someone with type 1 diabetes. After that, screening is recommended annually.


You can prevent or delay diabetic neuropathy and its complications by closely managing your blood sugar and taking good care of your feet.

  • Blood sugar managementit is recommended that people with diabetes have an A1C test at least twice a year. This test estimates your average blood sugar level for the past two to three months. If your blood sugar levels are higher than your goal, you may need changes in your daily management, such as adding or adjusting your medications or changing your diet.

  • Foot careFoot problems, including sores that don’t heal, ulcers, and even amputation, are common complications of diabetic neuropathy. But you can prevent many of these problems by having a thorough foot exam at least once a year, having your doctor check your feet at each office visit, and taking good care of your feet at home.

Follow your doctor’s recommendations for good foot care. To protect the health of your feet:

> Check your feet every day. Look for blisters, cuts, bruises, cracked and peeling skin, redness, and swelling. Use a mirror or ask a friend or family member to help examine parts of your feet that are hard to see.

> Keep your feet clean and dry. Wash your feet every day with lukewarm water and mild soap. Avoid soaking your feet. Dry your feet and between your toes carefully.

> Moisturize your feet. This helps prevent cracking. But don’t get lotion between your toes, because it might encourage fungal growth.

> Trim your toenails carefully. Cut your toenails straight across. File the edges carefully to avoid sharp edges.

> Wear clean, dry socks. Look for socks made of cotton or moisture-wicking fibers that don’t have tight bands or thick seams.

> Wear cushioned shoes that fit well. Always wear shoes or slippers to protect your feet. Make sure your shoes fit properly and allow your toes to move. A foot doctor can teach you how to buy properly fitted shoes and to prevent problems such as corns and calluses. If you qualify for Medicare, your plan may cover the cost of at least one pair of shoes each year.

Reach out to Integrated Pain Management today!

Having diabetes is already complicated enough, and the added stress of neuropathy and diabetes together can be overwhelming. Worry not, here at Integrated Pain Management, our team is dedicated to helping you develop a treatment plan tailored to your specific needs in managing both conditions. We understand your concerns and are committed to helping you return to an active lifestyle. Contact us today!