The majority of people with Diabetes have never heard of diabetic neuropathy - nerve damage that causes pain, numbness, or tingling in the feet and hands - researchers report.

Furthermore, only one in four people with symptoms of diabetic neuropathy had ever been diagnosed by their doctors.

“The numbers are spectacular,” said study author Dr. Aaron I. Vinik of the Strelitz Diabetes Research Institute in Norfolk, Virginia.

People with diabetes who experience any of the symptoms need to speak to their doctors right away, Vinik recommended. “Ask your doctor one question: Do I have neuropathy, and please would you mind examining me?”

Diabetic neuropathy Causes, incidence, and risk factors

People with diabetes commonly develop temporary or permanent damage to nerve tissue. Nerve injuries are caused by decreased blood flow and high blood-sugar levels, and are more likely to develop if blood-glucose levels are poorly controlled.

Some diabetics will not develop nerve damage, while others may develop this condition relatively early. On average, the onset of symptoms occurs 10 to 20 years after diabetes has been diagnosed. Approximately 50% of people with diabetes will eventually develop nerve damage.

Peripheral nerve injuries may affect cranial nerves or nerves from the spinal column and their branches. This type of neuropathy (nerve injury) tends to develop in stages. Early on, intermittent pain and tingling is noted in the extremities, particularly the feet. In later stages, the pain is more intense and constant. Finally, a painless neuropathy develops when pain sensation is lost to an area. This greatly increases the risk of severe tissue injury because pain no longer alerts the person to injury.

Autonomic neuropathies affect the nerves that regulate involuntary vital functions, including the heart muscle, smooth muscles and glands. Low blood pressure, diarrhea, constipation, sexual impotence, and other symptoms can be caused by autonomic neuropathies.

Diabetic neuropathy Symptoms

 
• Numbness  
• Tingling  
• Decreased sensation to a body part  
• Loss of sensation to a body part or area  
• Diarrhea  
• Constipation  
• Loss of bladder control  
• Impotence  
• Facial drooping  
• Drooping eyelid  
• Drooping mouth  
• Vision changes  
• Dizziness  
• Weakness  
• Swallowing difficulty  
• Speech impairment  
• Muscle contractions

Note: Symptoms vary depending on the nerve(s) affected and may include symptoms other than those listed. Symptoms usually develop gradually over years.

According to the American Diabetes Association, which commissioned the study, an estimated 50 percent of diabetics develop neuropathy.

People with neuropathy are at increased risk of foot injury and even amputation, because injuries can go unnoticed due to lack of sensation and then develop into ulcers or lesions that become infected.

Even without serious injuries, diabetics with neuropathy can become hypersensitive to even the lightest touch, so that wearing socks or touching bed sheets, for example, can be very painful.

For the study, Vinik and his team interviewed 8,119 people about diabetic neuropathy, whether they had any symptoms of the condition, and if it had ever been diagnosed.

The investigators found that more than 7 out of 10 diabetics said they had experienced symptoms of neuropathy in the past year.

However, 56 percent of the people who were having symptoms had never heard of diabetic neuropathy. Nearly 1 in 7 diabetics with symptoms of neuropathy who had mentioned their symptoms to their doctors said that their doctors had not mentioned anything about a potential cause.

The American Diabetes Association is launching a campaign to promote awareness of the symptoms of diabetic neuropathy, and what diabetics can do to prevent, reduce or manage the condition.