Diabetes

How Diabetes Gets On Your Nerves


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Summary & Participants

Almost half of all people with diabetes experience some form of nerve damage, which can develop into a complication known as peripheral neuropathy. What causes this condition, and how do you recognize the symptoms? Listen to leading experts explain.

Medically Reviewed On: July 21, 2012

Webcast Transcript


ANNOUNCER: Over 4 million Americans have diabetes. It is estimated that between 40 and 50 percent of these people will experience some form of nerve damage from their diabetes. Of this group, approximately one-third will develop a complication known as peripheral neuropathy.

RUSSELL K. PORTENOY, MD: The nervous system is divided into a central part, which consists of the brain and the spinal cord, and the peripheral part, which consists of all the nerves that travel into the body, including the extremities and the trunk and the internal organs.

ROY FREEMAN, MD: Peripheral neuropathy is the term that's used to describe damage, dysfunction, or even destruction of the nerves that go to the periphery of the body. So to the toes, the feet, the legs, the fingers, the hands, the arms, and sometimes the trunk, the chest, and even the head and the face.

ANNOUNCER: Nerve damage from diabetic peripheral neuropathy often cannot be reversed and can cause a variety of symptoms.

ASTRID ALMODOVAR, MD: In peripheral neuropathy we have, similar to schizophrenia, positive and negative symptoms. Positive symptoms would be burning, stinging, pins and needles. And, on the other side, the negative symptoms would be the absence of pain, anesthesia or paresthesia, when there is something there that should be felt.

ANNOUNCER: While peripheral neuropathy describes damage to any part of the peripheral nervous system, some patients with diabetes may also experience what's known as peripheral polyneuropathy. This is when many nerves of the peripheral nervous system do not work properly.

RUSSELL K. PORTENOY, MD: The earliest symptoms are typically numbness, tingling, or pain in the feet. Those symptoms can sometimes gradually ascend up the legs and ultimately move to involve both hands. The same kinds of symptoms, numbness, tingling and pain, will then affect the fingers, and can gradually travel up the hands and into the arms.

ANNOUNCER: The terms peripheral neuropathy and peripheral polyneuropathy are often used interchangeably, and diagnosis and treatment is the same for both.

There are many causes of peripheral neuropathy, including shingles, vitamin deficiencies, HIV, liver disease, and kidney disease, but diabetes is the leading cause in the United States.

Of the many symptoms associated with DPN, pain is the most distressing. The pain of DPN is potentially disabling and leads many patients to seek help.

ROY FREEMAN, MD: The pain can be present at rest and can be a burning sensation, a stabbing sensation, can be pins and needles that are uncomfortable, or it can be evoked by various stimuli. And some patients find it intolerable even to lie in bed; the contact merely with the bedclothes can be excruciatingly painful. Some patients find it difficult wearing shoes and socks, due to the discomfort of the peripheral neuropathy.

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