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Diabetic Neuropathy Types and Management

Effects of diabetes on the peripheral and autonomic nervous systems.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Diabetic Neuropathy Types and Management?

Diabetic neuropathy is a complication caused by chronic hyperglycemia damaging peripheral and autonomic nerves and affects up to 50% of patients with diabetes. Distal symmetric polyneuropathy (DSPN) is its most common form (75%).

DSPN presents with numbness, burning, and pain in a 'glove and stocking' distribution. Autonomic neuropathy may involve cardiovascular (orthostatic hypotension, resting tachycardia), gastrointestinal (gastroparesis), urogenital (erectile dysfunction, bladder dysfunction), and sudomotor (sweating disorders) systems.

Painful diabetic neuropathy seriously impairs quality of life. Glycemic control is the cornerstone of treatment; pregabalin, duloxetine, and gabapentin are first-line agents in the management of neuropathic pain.

Symptoms

Numbness, tingling, and burning in the feet
Increased pain at night
Touch hypersensitivity (allodynia)
Balance problems
Orthostatic hypotension and tachycardia (autonomic neuropathy)
Gastroparesis (early satiety, nausea, bloating)

Risk Factors

Long duration of diabetes
Poor glycemic control
Smoking
Hypertension and dyslipidemia
Obesity
Alcohol use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If numbness or burning develops in the feet
  • If balance problems and risk of falls increase
  • If there is orthostatic dizziness or fainting sensation
  • If marked bloating and nausea occur after meals

Treatment Methods

01
Optimal glycemic control (slows progression)
02
Neuropathic pain: pregabalin, duloxetine (first-line)
03
Gabapentin, amitriptyline (alternatives)
04
Topical capsaicin or lidocaine (local pain control)
05
Gastroparesis: metoclopramide, domperidone, small frequent meals
06
Orthostatic hypotension: midodrine, fludrocortisone, compression stockings

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.