Diabetic Neuropathy

Diabetes can harm your nerves. That damage, called neuropathy, may be painful. It can happen in several ways, and they all seem to be related to blood sugar levels being too high for too long. To prevent it, work with your doctor to manage your blood sugar. You may hear your doctor mention the four types of diabetes-related neuropathy: peripheral, autonomic, proximal, and focal.

Peripheral Neuropathy

This type usually affects the feet and legs. Rare cases affect the arms, abdomen, and back.

Symptoms include:

  • Tingling
  • Numbness (which may become permanent)
  • Burning (especially in the evening)
  • Pain

Early symptoms usually get better when your blood sugar is under control. There are medications to help manage the discomfort.

What you should do:

  • Check your feet and legs daily.
  • Use lotion on your feet if they're dry.
  • Take care of your toenails. Ask your doctor if you should go to a podiatrist.
  • Wear shoes that fit well. Wear them all the time, so your feet don't get injured.

 Autonomic Neuropathy

This type usually affects the digestive system, especially the stomach. It can also affect the blood vessels, urinary system, and sex organs.

In your digestive system:

Symptoms include:

  • Bloating
  • Diarrhea
  • Constipation
  • Heartburn
  • Nausea
  • Vomiting
  • Feeling full after small meals

What you should do: You may need to eat smaller meals and take medication to treat it.

Symptoms include: 

  • Blacking out when you stand up quickly
  • Faster heartbeat
  • Dizziness
  • Low blood pressure
  • Nausea
  • Vomiting
  • Feeling full sooner than normal

If you have it: Avoid standing up too quickly. You may also need to wear special stockings (ask your doctor about them) and take medicine.

In Men:

Symptoms include: He may not be able to have or keep an erection, or he may have “dry” or reduced ejaculations. 

What you should do: See your doctor, because there are other possible causes than diabetes. Treatment includes:

  • Counseling
  • Penile implant or injections
  • Vacuum erection device
  • Medication

In Women

Symptoms include: Can include less vaginal lubrication and fewer or no orgasms.

What you should do: See your doctor. Treatments include:

  • Vaginal estrogen creams, suppositories, and rings
  • Medications to help sex not feel painful
  • Lubricants

In the Urinary System:

Symptoms include:

  • Trouble emptying your bladder
  • Bloating
  • Incontinence (leaking urine)
  • More bathroom trips at night

What you should do: Tell your doctor. Treatments may include:

  • Medication
  • Inserting a catheter into the bladder to release urine (self-catheterization)
  • Surgery



Gastroparesis, also called “paralyzed stomach” is a serious condition manifested by delayed emptying of stomach contents into the small intestine after a meal. Young and middle-aged women are at the highest risk for developing idiopathic gastroparesis.


The common symptoms are-

  • Chronic nausea
  • Vomiting (especially of undigested food)
  • Abdominal pain
  • Feeling of fullness after just a few bites
  • Lack of appetite
  • Gastroesophageal reflux
  • Spasms of the stomach wall
  • Weight loss and malnutrition


Most people diagnosed with gastroparesis have idiopathic gastroparesis. The primary cause of gastroparesis is damage to or dysfunction of peripheral nerves and muscles. Other factors include:

  • Vagus nerve damage
  • Uncontrolled diabetes
  • Certain medications i.e. tricyclic antidepressants, calcium channel blockers, clonidine, dopamine agonists, lithium, nicotine, and progesterone
  • Conditions such as Parkinson's disease, multiple sclerosis, amyloidosis, and scleroderma
  • Viral infection
  • Radiation therapy or chemotherapy
  • Hypothyroidism
  • Abdominal or esophageal surgery
  • Scleroderma (a connective tissue disease)


  • Upper gastrointestinal endoscopy
  • CT scan, MRI, and ultrasound
  • Upper GI seriesor barium X-ray
  • Gastric emptying study
  • Electrogastrography
  • Wireless capsule test
  • Scintigraphic gastric accommodation
  • Small intestine X-ray


1. Dietary changes

      Eat smaller meals more frequently

  • Chew food thoroughly
  • Avoid fibrous fruits & vegetables, fatty foods and carbonated drinks
  • Drink water throughout each meal

2. Medications

  • To stimulate the stomach muscles- Metoclopramide, erythromycin, Domperidone.
  • To control nausea and vomiting- Prochlorperazine,thiethylperazine,ondansetronand diphenhydramine.

3. Surgery

  Dhaka -

Saturday 20 Jan 2018

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