Diabetes effect on Nervous System Part II, Diabetic Neuropathy, How is it Treated?

How is it Treated?

Firstly it is important to determine if the pain is due to diabetes or some other cause. People with pain should have a thorough assessment.

    Pain due to diabetes is usually:

  • present in both feet
  • of equal severity in each
  • often, but not always, worse at night

If the pain is in one foot only, it is likely from another cause such as arthritis, spinal problems, other neuropathies or peripheral vascular disease, which should be investigated by your doctor.

Painful diabetic neuropathy is not easy to treat, but many options are available and it would be best to discuss these options with your doctor and choose those which may be the best for you. It is important to understand that for some people, several treatments may need to be tried or used in combination to achieve acceptable symptom relief.

Autonomic Neuropathy

Autonomic nerves go from your spinal cord to your lungs, heart, stomach, intestines, bladder, and sex organs.

Diabetic autonomy neuropathy produces changes in many processes and systems, although all the organs may not be affected at the same time or to the same degree.

Cardiovascular system

Autonomic neuropathy can affect the cardiovascular system, which controls the circulation of blood throughout the body. Damage to this system interferes with the nerve impulses from various parts of the body that signal the need for blood and regulate blood pressure and heart rate. Damage to these nerves makes your blood move too slowly to keep your blood pressure steady when you change position. When you go from lying down to standing up or when you exercise a lot, the sudden changes in blood pressure can make you dizzy.As a result, blood pressure may drop sharply after sitting or standing, causing a person to feel dizzy or light-headed, or even to faint (orthostatic hypotension).

Neuropathy that affects the cardiovascular system may also affect the perception of pain from heart disease. People may not experience angina as a warning sign of heart disease or may suffer painless heart attacks. It may also raise the risk of a heart attack during general anesthesia.

Urination and sexual response

Autonomic neuropathy most often affects the organs that control urination and sexual function. Nerve damage can prevent the bladder from emptying completely, so bacteria grow more easily in the urinary tract (bladder and kidneys). When the nerves of the bladder are damaged, a person may have difficulty knowing when the bladder is full or controlling it, resulting in urinary incontinence.

The nerve damage and circulatory problems of diabetes can also lead to a gradual loss of sexual response in both men and women, although sex drive is unchanged. A man may be unable to have erections or may reach sexual climax without ejaculating normally.

Damage to these nerves prevents a woman’s vagina from getting wet when she wants to have sex. A woman might also have less feeling around her vagina.


Autonomic neuropathy can affect digestion. Nerve damage can cause the stomach to empty too slowly, a disorder called gastric stasis. When the condition is severe (gastroparesis), a person can have persistent nausea and vomiting, bloating, and loss of appetite. When nerves to the stomach are damaged, the muscles of the stomach do not work well and food may stay in the stomach too long. Gastroparesis makes it hard to keep blood sugar under control, and levels tend to fluctuate greatly with this condition. If nerves in the esophagus are involved, swallowing may be difficult. Nerve damage to the bowels can cause constipation or frequent diarrhea, especially at night. Problems with the digestive system often lead to weight loss.


Autonomic neuropathy can hinder the body’s normal response to low blood sugar or hypoglycemia, which makes it difficult to recognize and treat an insulin reaction. Some people take diabetes medicines that can accidentally make their blood sugar too low. Damage to the autonomic nerves can make it hard for them to feel the symptoms of hypoglycemia, which is the medical name for low blood sugar.

This kind of damage is more likely to happen if you have had diabetes for a long time. It can also happen if your blood sugar has been too low very often.


Autonomic neuropathy can affect the nerves that control sweating. Sometimes, nerve damage interferes with the activity of the sweat glands, making it difficult for the body to regulate its temperature. Other times, the result can be profuse sweating at night or while eating (gustatory sweating).

Thus, diabetic neuropathy can affect virtually any part of the body!

How do I know I have diabetic neuropathy?

    You may have diabetic neuropathy if you have any of the following:

  • Pain in your legs
  • Numbness in your feet and toes
  • A feeling of lightheadedness that causes you to fall
  • Diarrhea or constipation
  • Failure to get erections (in men)

Tell your doctor right away if you get any of these signs.


Many of you may have no symptoms or these may be so minor that you may not pay attention to them. It is therefore, so necessary to have a regular checkup done with your doctor so that the presence of diabetic nerve damage can be diagnosed early. As an example, insensitive feet can be diagnosed at the earliest and steps taken to avoid major complications such as foot ulcers!

Although many of you will get some degree of diabetic nerve damage, it can be kept at a level which does not interfere with your daily life and routine. There is no need to be afraid of diabetic neuropathy.

Don’t lose your nerve and your nerves won’t let you down!

About Anuj Agarwal

I am a professional with varied working experience of more than 18 years in India, USA and Middle East. My areas of work and interest are Information Technology, Corporate Social Responsibility, Health and Wellness. Please feel free to contact me through the blog or write me at agarwalanuj@yahoo.com
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7 Responses to Diabetes effect on Nervous System Part II, Diabetic Neuropathy, How is it Treated?

  1. Catherine Nieves says:

    This article “Diabetes effect on Nervous System Part II, Diabetic Neuropathy, How is it Treated?” does an adequate job of explaining the damage diabetic neuropathy can cause to various systems. But there is no articulation of efficacious treatments. “Tell your doctor right away if you have symptoms. ..” is advise I wholeheartedly endorse, but in this curent environment when doctors are loathe to spend more than 15 minutes with any patient, the onus is on the patient to educate themselves if they indeed want to be educated. This article does not provide the education advertised in its title. More information please.

  2. intrec1@aol.com says:

    Any info on Neur-vasia?

  3. Pingback: Diabetes effect on Nervous System Part II, Diabetic Neuropathy, How is it Treated? « healthsewak.com

  4. Pingback: Diabetic Neuropathy. Effectiveness of different benfotiamine dosage regimens in the treatment of painful diabetic neuropathy.

  5. Pingback: 3 Myths About Neuropathy Exposed - Neurvasia

  6. Pingback: Peripheral neuropathy – MayoClinic.com « Earl's View

  7. Pingback: VA Seeks Comment on Rule Allowing Service Connected Presumption for Peripheral Neuropathy « Veterans Disability Blog

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