One of the most common diabetes complications is nerve damage. You may experience neuropathy in your feet, toes, legs, and arms. It may come and go, ranging from numbness to more severe shooting pain. Medications may help along with managing blood sugar levels.

“Neuropathy” refers to any condition that damages nerve cells. These cells play a critical role in touch, sensation, and movement.

Diabetic neuropathy is damage of the nerves that’s caused by diabetes. Scientists believe that the high content of blood sugar in the blood of a person with diabetes damages nerves over time.

There are several different types of neuropathies. They include:

  • peripheral: pain and numbness in the extremities, including arms, hands, legs, feet, and toes
  • proximal: pain and numbness in the upper legs, specifically the buttocks, thighs, and hips
  • autonomic: damage to nerves of the autonomic nervous system, which control sexual response, sweating, and urinary and digestive function
  • focal: sudden loss of function in nerves causing pain and weakness of the muscles

Neuropathy is one of the common effects of diabetes. It’s estimated that 60 to 70 percent of people with diabetes will develop some sort of neuropathy throughout their lives.

By 2050, it’s estimated that over 48 million people in the United States will be diagnosed with diabetes. That means in the future, anywhere from 29 to 34 million Americans could be affected by diabetic neuropathy.

Nerve damage from diabetes can’t be reversed. This is because the body can’t naturally repair nerve tissues that have been damaged.

However, researchers are investigating methods to treat nerve damage caused by diabetes.

While you can’t reverse the damage from neuropathy, there are ways to help manage the condition, including:

  • lowering your blood sugar
  • treating nerve pain
  • regularly checking your feet to make sure they are free of injury, wounds, or infection

Managing your blood glucose is important because it can help prevent additional damage to your nerves. You can better manage your blood glucose through the following methods:

  • Avoid foods high in excess sugars, including sodas, sweetened drinks and coffees, fruit juices, and processed snacks and candy bars.
  • Eat foods high in fiber. These foods typically help keep blood sugars at a steady state.
  • Eat foods that contain healthy fats, like those from olive oil and nuts, and choose lean proteins like chicken and turkey.
  • Eat vegetables and plant-based proteins regularly, such as beans and tofu.
  • Exercise at least five times a week, 30 minutes each time. Include aerobic activity and weight training in your routine.
  • Monitor your blood sugar according to your doctor’s recommendation and record your levels. This will help you identify patterns and unusual changes in your blood sugar levels.
  • Take insulin or oral medications, such as metformin (Glucophage), as instructed by your endocrinologist or primary care doctor.

In addition to managing your blood glucose levels, it’s important to pay attention to your feet and legs. Nerves in the legs and feet can be damaged, which can lead to reduced feeling. This means that you may not notice it if you cut or injure your foot or leg.

To prevent damage to your feet or legs:

  • regularly check your feet for open wounds or sores
  • clip your toenails
  • wash your feet with soap and water regularly
  • regularly visit a podiatrist
  • avoid walking barefoot

According to guidelines from the American Academy of Neurology, the most effective medications for treating painful diabetic neuropathy (PDN) include:

  • pregabalin (Lyrica)
  • gabapentin (Neurontin)
  • duloxetine (Cymbalta)
  • venlafaxine (Effexor)
  • amitriptyline

Other suggested treatment options may include:

  • topical medications, like capsaicin (Qutenza)

Glucose management is a highly effective way of reducing symptoms and the progression of neuropathy. Managing your glucose levels should always be a part of your treatment plan.

Off-label drug use

Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that it hasn’t been approved for. However, a doctor can still use the drug for that purpose.

The FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. Therefore, your doctor can prescribe a drug that they think is best for your care.

Nerves have many important functions in the body. That is why diabetic neuropathy can lead to many complications.

Digestive issues

Nerves damaged by neuropathy can negatively affect organs in your digestive system. This can lead to:

  • nausea
  • vomiting
  • impaired hunger
  • constipation
  • diarrhea

Additionally, it can affect how food moves within your stomach and intestines. These problems can lead to poor nutrition and, over time, blood sugar levels that are more difficult to manage.

Sexual dysfunction

If you have autonomic neuropathy, the nerves that impact sexual organs may be harmed. This can lead to:

  • erectile dysfunction in males
  • issues with sexual arousal and vaginal lubrication in females
  • impaired stimulation in both males and females

Infection in legs and feet

Nerves in the legs and feet are often most affected by neuropathy. This can cause you to lose sensation to your feet and legs. Sores and cuts can go unnoticed and lead to infections.

In some extreme cases, infections can become severe and lead to ulcers. Over time, this can cause irreparable damage to the soft tissue and lead to the loss of toes or even your foot.

Joint damage in the legs

Damage to the nerves in your legs can lead to something called a Charcot joint. This results in swelling, numbness, and lack of joint stability.

Excess or reduced sweating

Nerves impact the function of sweat glands, so damage to nerves could affect the functioning of your sweat glands.

This can lead to anhydrosis, also known as reduced sweating, or hyperhidrosis, also known as excess sweating. As a result, this may affect body temperature regulation.

Urinary problems

Nerves play an important role in managing the bladder and urinary system. If the nerves that affect these systems are damaged, this can lead to the inability to recognize when the bladder is full and poor control of urination.

Neuropathy is most commonly caused by diabetes, but it may be caused by other conditions, including:

  • alcohol use disorder
  • exposure to toxins
  • tumors
  • abnormal levels of vitamin B and vitamin E
  • trauma that causes pressure to nerves
  • autoimmune diseases and infections
  • side effects of certain medications, such as chemotherapy

Diabetic neuropathy is common and can’t be reversed. However, you can manage it through a variety of ways. These include:

  • managing blood glucose levels
  • taking medications your doctor has prescribed for the treatment of neuropathy
  • regularly self-checking your feet and legs for injury
  • talking with your doctor and working with them to manage your condition