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Content Map Terms
Illnesses & Conditions Categories
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Allergies
- Allergy to Natural Rubber (Latex)
- Jellyfish Stings: Allergic Reaction
- Allergies: Should I Take Allergy Shots?
- Non-Allergic Rhinitis
- Allergic Reaction
- Allergies
- Allergy Shots for Allergic Rhinitis
- Allergies: Rush Immunotherapy
- Over-the-Counter Medicines for Allergies
- Allergic Rhinitis
- Types of Allergens
- Allergies: Avoiding Indoor Triggers
- Allergies: Avoiding Outdoor Triggers
- Controlling Dust, Dust Mites, and Other Allergens in Your Home
- Controlling Pet Allergens
- Allergies to Insect Stings
- Allergies: Should I Take Shots for Insect Sting Allergies?
- Immunotherapy for Allergies to Insect Stings
- Types of Allergic Rhinitis
- Allergic Reaction to Tattoo Dye
- Drug Allergies
- Penicillin Allergy
- Hay Fever and Other Seasonal Allergies
- Allergies: Giving Yourself an Epinephrine Shot
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Arthritis and Osteoporosis
- Rheumatoid Arthritis: Finger and Hand Surgeries
- Rheumatoid Arthritis: Classification Criteria
- Rheumatoid Arthritis: Systemic Symptoms
- Comparing Rheumatoid Arthritis and Osteoarthritis
- Rheumatoid Arthritis: Neck Symptoms
- Osteoporosis in Men
- Psoriatic Arthritis
- Arthritis: Shots for Knee Pain
- Complementary Medicine for Arthritis
- Steve's Story: Coping With Arthritis
- Bev's Story: Coping With Arthritis
- Quick Tips: Modifying Your Home and Work Area When You Have Arthritis
- Coping With Osteoarthritis
- Arthritis: Should I Have Shoulder Replacement Surgery?
- Juvenile Idiopathic Arthritis: Stretching and Strengthening Exercises
- Juvenile Idiopathic Arthritis
- Capsaicin for Osteoarthritis
- Small Joint Surgery for Osteoarthritis
- Osteoarthritis: Heat and Cold Therapy
- Modifying Activities for Osteoarthritis
- Osteoarthritis
- Gout
- Rheumatoid Arthritis
- Juvenile Idiopathic Arthritis: Inflammatory Eye Disease
- Juvenile Idiopathic Arthritis: Range-of-Motion Exercises
- Juvenile Idiopathic Arthritis: Deciding About Total Joint Replacement
- Complications of Osteoarthritis
- Arthritis: Managing Rheumatoid Arthritis
- Arthritis: Should I Have Knee Replacement Surgery?
- Arthritis: Should I Have Hip Replacement Surgery?
- Juvenile Idiopathic Arthritis: Pain Management
- Osteoporosis Risk in Younger Women
- Osteoporosis Screening
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Asthma
- Asthma: Peak Expiratory Flow and Personal Best
- Asthma and Wheezing
- Asthma: Using an Asthma Action Plan
- Asthma: Measuring Peak Flow
- Asthma: Identifying Your Triggers
- Steroid Medicine for Asthma: Myths and Facts
- Asthma
- Inhaled corticosteroids for asthma
- Inhaled quick-relief medicines for asthma
- Classification of Asthma
- Challenge Tests for Asthma
- Asthma's Impact on Your Child's Life
- Asthma Action Plan: Yellow Zone
- Asthma Triggers
- Asthma Action Plan: Red Zone
- Asthma and GERD
- Occupational Asthma
- Asthma Attack
- Asthma: Symptoms of Difficulty Breathing
- Exercise-Induced Asthma
- Asthma Treatment Goals
- Asthma: Overcoming Obstacles to Taking Medicines
- Asthma in Older Adults: Managing Treatment
- Asthma: Controlling Cockroaches
- Asthma: Educating Yourself and Your Child
- Allergy Shots for Asthma
- Asthma: Taking Charge of Your Asthma
- Monitoring Asthma Treatment
- Omalizumab for Asthma
- Asthma: Ways to Take Inhaled Medicines
- Asthma: Overuse of Quick-Relief Medicines
- Asthma Diary
- Asthma Diary Template
- Asthma Action Plan
- Assessing Your Asthma Knowledge
- My Asthma Action Plan
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Bowel and Gastrointestinal Conditions
- Abdominal Fullness or Bloating
- Irritable Bowel Syndrome: Criteria for Diagnosis
- Gastritis
- Gas, Bloating, and Burping
- Irritable Bowel Syndrome (IBS)
- Constipation: Keeping Your Bowels Healthy
- Rectal Problems
- Mild, Moderate, or Severe Diarrhea
- Torn or Detached Nail
- Chronic Constipation
- Gas (Flatus)
- Dyspepsia
- Diverticulosis
- Bowel Obstruction
- Anal Fissure
- Bowel Disease: Caring for Your Ostomy
- Anal Fistulas and Crohn's Disease
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Cancer
- Lung Cancer and Other Lung Problems From Smoking
- Skin Cancer, Non-Melanoma
- Radiation Therapy for Non-Melanoma Skin Cancer
- Colorectal Cancer Test Recommendations
- Breast Cancer Screening: When Should I Start Having Mammograms?
- Lifestyle Changes That May Help Prevent Cancer
- Choosing a Prosthesis After Breast Cancer Surgery
- Hormone Treatment for Breast Cancer
- Cancer Staging and Grading
- Pancreatic Cancer
- Kidney (Renal Cell) Cancer
- Cancer Support: Managing Stress
- Cancer Support: When Your Cancer Comes Back or Gets Worse
- Cancer Support: Dealing With Emotions and Fears
- Cancer Support: Finding Out That You Have Cancer
- Cancer Support: Being an Active Patient
- Cancer Support: Coping With Cancer Treatments
- Cancer Support: Life After Treatment
- Cancer Support: Family, Friends, and Relationships
- Reducing Cancer Risk When You Are BRCA-Positive
- Anal Cancer
- Prostate Cancer: Should I Choose Active Surveillance?
- Lung Cancer Screening
- Basal Cell Skin Cancer: Should I Have Surgery or Use Medicated Cream?
- Tumour Markers
- Does Aspirin Prevent Cancer?
- Cancer
- Lung Cancer
- Oral Cancer
- Colorectal Cancer
- Metastatic Melanoma
- Radiation Treatment for Cancer
- Skin Cancer, Melanoma
- Cervical Cancer Screening
- Hepatitis B and C: Risk of Liver Cancer
- Inflammatory Bowel Disease and Cancer Risk
- Radiation Therapy for Prostate Cancer
- Prostate Cancer
- Cancer: Home Treatment for Mouth Sores
- Skin Cancer Screening
- Breast Cancer: Should I Have Breast Reconstruction After a Mastectomy?
- Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?
- Prostate Cancer Screening
- Side Effects of Chemotherapy
- Breast Cancer: Lymph Node Surgery for Staging Cancer
- Endometrial (Uterine) Cancer
- Cryosurgery for Prostate Cancer
- Breast Cancer
- Cancer: Home Treatment for Nausea or Vomiting
- Cancer: Home Treatment for Pain
- Cancer: Home Treatment for Diarrhea
- Cancer: Home Treatment for Constipation
- Breast Cancer Types
- Cancer: Home Treatment for Sleep Problems
- Cancer: Home Treatment for Fatigue
- Hair Loss From Cancer Treatment
- Body Image After Cancer Treatment
- Breast Cancer: Should I Have Breast-Conserving Surgery or a Mastectomy for Early-Stage Cancer?
- Breast Cancer, Metastatic or Recurrent
- Cancer Pain
- Leukemia
- Colorectal Cancer, Metastatic or Recurrent
- Thyroid Cancer
- Types of Thyroid Cancer
- Radiation Therapy for Cancer Pain
- Breast Cancer in Men (Male Breast Cancer)
- Breast Cancer Screening
- Breast Cancer: Should I Have Chemotherapy for Early-Stage Breast Cancer?
- Asbestos and Lung Cancer
- Cervical Cancer
- Ovarian Cancer
- Colon Cancer Genetic Testing
- Testicular Cancer Screening
- Skin Cancer: Protecting Your Skin
- Non-Melanoma Skin Cancer: Comparing Treatments
- Bladder Cancer
- Prostate Cancer, Advanced or Metastatic
- Active Surveillance for Prostate Cancer
- Urinary Problems and Prostate Cancer
- Cancer: Controlling Cancer Pain
- Heat and Cold Treatment for Cancer Pain
- Testicular Cancer
- Testicular Cancer: Which Treatment Should I Have for Stage I Non-Seminoma Testicular Cancer After My Surgery?
- Testicular Cancer: Which Treatment Should I Have for Stage I Seminoma Testicular Cancer After My Surgery?
- Cancer: Controlling Nausea and Vomiting From Chemotherapy
- Lymphedema: Managing Lymphedema
- Breast Cancer Risk: Should I Have a BRCA Gene Test?
- Inflammatory Breast Cancer
- Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
- Family History and the Risk for Breast or Ovarian Cancer
- Breast Cancer: What Should I Do if I'm at High Risk?
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Cold and Flu
- Difference Between Influenza (Flu) and a Cold
- Colds and Flu
- Influenza (Flu) Complications
- Flu Vaccine Myths
- Influenza (Seasonal Flu)
- Whooping Cough (Pertussis)
- Productive Coughs
- Dry Coughs
- Influenza (Flu): Should I Take Antiviral Medicine?
- Flu Vaccines: Should I Get a Flu Vaccine?
- Relieving A Cough
- Colds
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COPD
- Cal's Story: Learning to Exercise When You have COPD
- Conserving Energy When You Have COPD or Other Chronic Conditions
- Nebulizer for COPD Treatment
- COPD Action Plan
- COPD: Help for Caregivers
- COPD: Keeping Your Diet Healthy
- COPD: Using Exercise to Feel Better
- COPD
- COPD Flare-Ups
- Bullectomy for COPD
- COPD and Alpha-1 Antitrypsin (AAT) Deficiency
- COPD and Sex
- Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease (COPD)
- COPD
- Oxygen Treatment for Chronic Obstructive Pulmonary Disease (COPD)
- COPD: Avoiding Weight Loss
- COPD: Avoiding Your Triggers
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Dementia
- Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?
- Alzheimer's and Other Dementias: Coping With Sundowning
- Dementia: Assessing Pain
- Medical History and Physical Examination for Dementia or Alzheimer's Disease
- Alzheimer's and Other Dementias: Making the Most of Remaining Abilities
- Dementia: Helping a Person Avoid Confusion
- Alzheimer's and Other Dementias: Maintaining Good Nutrition
- Dementia: Tips for Communicating
- Agitation and Dementia
- Dementia: Bladder and Bowel Problems
- Dementia: Support for Caregivers
- Dementia: Legal Issues
- Dementia: Understanding Behaviour Changes
- Dementia: Medicines to Treat Behaviour Changes
- Dementia
- Mild Cognitive Impairment and Dementia
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Diabetes
- Diabetes: Blood Sugar Levels
- Diabetes: Counting Carbs if You Don't Use Insulin
- Diabetes: Coping With Your Feelings About Your Diet
- Diabetes: Tracking My Feelings
- Diabetes: Taking Care of Your Feet
- Diabetes: Care of Blood Sugar Test Supplies
- Diabetes: Checking Your Blood Sugar
- Diabetes: Checking Your Feet
- Diabetes: Steps for Foot-Washing
- Diabetes: Protecting Your Feet
- Diabetes: Dealing With Low Blood Sugar From Medicines
- Diabetes: Dealing With Low Blood Sugar From Insulin
- Diabetes: How to Give Glucagon
- Low Blood Sugar Level Record
- Symptoms of Low Blood Sugar
- Diabetes: Preventing High Blood Sugar Emergencies
- Diabetic Ketoacidosis (DKA)
- High Blood Sugar Level Record
- Symptoms of High Blood Sugar
- Diabetes: Using a Plate Format to Plan Meals
- Diabetes: Giving Yourself an Insulin Shot
- Diabetes: Eating Low-Glycemic Foods
- Diabetes and Alcohol
- Continuous Glucose Monitoring
- Quick Tips: Diabetes and Shift Work
- Diabetes: How to Prepare for a Colonoscopy
- Type 2 Diabetes: Can You Cure It?
- Diabetes, Type 2: Should I Take Insulin?
- Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?
- Diabetes: Making Medical Decisions as Your Health Changes
- Diabetes Care Plan
- Diabetes: Caregiving for an Older Adult
- Quick Tips: Smart Snacking When You Have Diabetes
- Testing Tips From a Diabetes Educator
- Gloria's Story: Adding Activity to Help Control Blood Sugar
- Andy's Story: Finding Your Own Routine When You Have Diabetes
- Jerry's Story: Take Prediabetes Seriously
- Linda's Story: Getting Active When You Have Prediabetes
- Diabetes
- Tips for Exercising Safely When You Have Diabetes
- Diabetes: Travel Tips
- Type 2 Diabetes
- Type 1 Diabetes
- Care of Your Skin When You Have Diabetes
- Care of Your Teeth and Gums When You Have Diabetes
- Non-insulin medicines for type 2 diabetes
- Metformin for diabetes
- Hypoglycemia (Low Blood Sugar) in People Without Diabetes
- Diabetic Retinopathy
- Laser Photocoagulation for Diabetic Retinopathy
- Diabetic Neuropathy
- Diabetic Focal Neuropathy
- Diabetic Neuropathy: Exercising Safely
- Diabetic Autonomic Neuropathy
- Criteria for Diagnosing Diabetes
- Diabetes-Related High and Low Blood Sugar Levels
- Diabetic Nephropathy
- Diabetes: Counting Carbs if You Use Insulin
- Diabetes: Cholesterol Levels
- Diabetes and Infections
- Diabetes: Tests to Watch for Complications
- Diabetes: Differences Between Type 1 and 2
- Diabetes Complications
- How Diabetes Causes Blindness
- How Diabetes Causes Foot Problems
- Reading Food Labels When You Have Diabetes
- Eating Out When You Have Diabetes
- Breastfeeding When You Have Diabetes
- Diabetes: Staying Motivated
- Sick-Day Guidelines for People With Diabetes
- Diabetes: Amputation for Foot Problems
- Prediabetes
- Prediabetes: Exercise Tips
- Type 2 Diabetes: Screening for Adults
- Diabetes: Should I Get an Insulin Pump?
- Diabetes: Living With an Insulin Pump
- Form for Carbohydrate Counting
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Disease and Disease Prevention
- Diseases and Conditions
- Osgood-Schlatter Disease
- Needle Aponeurotomy for Dupuytren's Disease
- Mitochondrial Diseases
- Disease and Injury Prevention
- Alzheimer's Disease
- Root Planing and Scaling for Gum Disease
- Kawasaki Disease
- Tay-Sachs Disease
- Von Willebrand's Disease
- Hirschsprung's Disease
- Complications of Paget's Disease
- Paget's Disease of Bone
- Celiac Disease
- Peptic Ulcer Disease
- Ménière's Disease
- Pelvic Inflammatory Disease: Tubo-Ovarian Abscess
- Pelvic Inflammatory Disease
- Addison's Disease
- Misdiagnosis of Lyme Disease
- Lyme Disease
- Parkinson's Disease and Freezing
- Parkinson's Disease: Other Symptoms
- Parkinson's Disease: Modifying Your Activities and Your Home
- Parkinson's Disease and Tremors
- Parkinson's Disease and Speech Problems
- Parkinson's Disease
- Disease-modifying antirheumatic drugs (DMARDs)
- Parkinson's Disease: Movement Problems From Levodopa
- Mad Cow Disease
- Handwashing
- Peyronie's Disease
- Stages of Lyme Disease
- Osteotomy and Paget's Disease
- Dupuytren's Disease
- Crohn's Disease
- Crohn's Disease: Problems Outside the Digestive Tract
- Pilonidal Disease
- Acquired Von Willebrand's Disease
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Down Syndrome, Autism and Developmental Delays
- Autism
- Down Syndrome: Helping Your Child Eat Independently
- Down Syndrome: Grooming and Hygiene
- Down Syndrome: Helping Your Child Learn to Walk and Use Other Motor Skills
- Down Syndrome: Helping Your Child Learn to Communicate
- Down Syndrome
- Dyslexia
- Conditions Related to Dyslexia
- Autism: Behavioural Training and Management
- Autism: Support and Training for the Family
- Unproven Treatments for Autism
- Caring for Adults With Autism
- Down Syndrome: Helping Your Child Avoid Social Problems
- Down Syndrome: Training and Therapy for Young People
- Down Syndrome: Helping Your Child Dress Independently
- Down Syndrome, Ages Birth to 1 Month
- Down Syndrome, Ages 1 Month to 1 Year
- Down Syndrome, Ages 1 to 5
- Down Syndrome, Ages 5 to 13
- Down Syndrome, Ages 13 to 21
- Eating Disorders
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Epilepsy
- Absence Epilepsy
- Juvenile Myoclonic Epilepsy
- Temporal Lobe Epilepsy
- Focal Epilepsy
- Epilepsy: Simple Partial Seizures
- Epilepsy
- Epilepsy and Driving
- Epilepsy: Generalized Seizures
- Epilepsy: Generalized Tonic-Clonic Seizures
- Epilepsy: Myoclonic Seizures
- Epilepsy: Atonic Seizures
- Epilepsy: Tonic Seizures
- Epilepsy: Complex Partial Seizures
- Epilepsy Medicine Therapy Failure
- Stopping Medicine for Epilepsy
- Questions About Medicines for Epilepsy
- Epilepsy: Taking Your Medicines Properly
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Fatigue and Sleep
- Sleep Apnea: Should I Have a Sleep Study?
- Sleep and Your Health
- Quick Tips: Making the Best of Shift Work
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Managing Your Energy
- Sleeping Better
- Sleep Problems
- Doxepin (Sleep) - Oral
- Improving Sleep When You Have Chronic Pain
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
- Chronic Fatigue: Changing Your Schedule
- Chronic Fatigue: Getting Support
- Snoring and Obstructive Sleep Apnea
- Coping With Changing Sleep Patterns as You Get Older
- Stages of Sleep
- Sleep Apnea: Fibre-Optic Pharyngoscopy
- Sleep Apnea: Oral Devices
- Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea
- Sleep Apnea
- Sleep Problems, Age 12 and Older
- Stages of Sleep Apnea
- Sleep Journal
- Shift Work Sleep Disorder
- Snoring
- Sleep Problems: Dealing With Jet Lag
- Insomnia
- Sleep and Your Body Clock
- Weakness and Fatigue
- Insomnia: Improving Your Sleep
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Heart Health and Stroke
- Peripheral Arterial Disease of the Legs
- Bradycardia (Slow Heart Rate)
- Types of Bradycardia
- Cardiac Device Monitoring
- Angioplasty for Peripheral Arterial Disease of the Legs
- Isolated Systolic High Blood Pressure
- Atrial Fibrillation: Should I Try Electrical Cardioversion?
- Change in Heartbeat
- Deep Vein Thrombosis
- Fast Heart Rate
- Heart Failure: Symptom Record
- Heart Failure: Compensation by the Heart and Body
- Heart Failure: Taking Medicines Properly
- Heart Failure: Watching Your Fluids
- Heart Failure: Avoiding Triggers for Sudden Heart Failure
- Heart Failure: Activity and Exercise
- Heart Tests: When Do You Need Them?
- Low Blood Pressure (Hypotension)
- Cardiac Arrest
- Heart Failure Daily Action Plan
- Premature Ventricular Contractions (PVCs)
- Heart Rate Problems: Should I Get a Pacemaker?
- Heart Rhythm Problems: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- What to Do if Your Cardiac Device Is Recalled
- Venous Insufficiency
- Carotid Artery Stenting
- ICD: Living Well With It
- Diabetes: Lower Your Risk for Heart Attack and Stroke
- Pacemaker for Heart Failure (Cardiac Resynchronization Therapy)
- Heart Attack: How to Prevent Another One
- Stroke: How to Prevent Another One
- Sex and Your Heart
- Supraventricular Tachycardia: Should I Have Catheter Ablation?
- Carotid Artery Disease
- Giant Cell Arteritis
- High Blood Pressure: Over-the-Counter Medicines to Avoid
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Leg Aneurysm
- Pulmonary Hypertension
- Left Ventricular Hypertrophy (LVH)
- Heart Failure: Checking Your Weight
- Alan's Story: Coping With Change After a Heart Attack
- Coronary Artery Disease: Prevention Myths
- Quick Tips: Taking Charge of Your Angina
- Heart and Circulation
- High Blood Pressure
- Heartburn
- Angioplasty for Coronary Artery Disease
- Coronary Artery Disease
- Implantable Cardioverter-Defibrillator (ICD)
- Aortic Valve Regurgitation
- Aortic Valve Stenosis
- Secondary High Blood Pressure
- Hemorrhagic Stroke
- Stroke: Common Disabilities
- Self-Care After a Stroke
- Stroke: Dealing With Depression
- Stroke: Getting Dressed
- Stroke: Speech and Language Problems
- Stroke: Bladder and Bowel Problems
- Stroke: Preventing Injury in Affected Limbs
- After a Stroke: Helping Your Family Adjust
- Stroke: Behaviour Changes
- Stroke: Changes in Emotions
- Stroke: Perception Changes
- Stroke: Problems With Ignoring the Affected Side
- Stroke: Memory Tips
- Stroke: Your Rehabilitation Team
- Stroke
- Transient Ischemic Attack (TIA)
- Cardiac Rehabilitation: Lifestyle Changes
- Cardiac Rehabilitation: Hospital Program
- Cardiac Rehabilitation: Home Program
- Cardiac Rehabilitation: Outpatient Program
- Cardiac Rehabilitation: Maintenance Program
- Congenital Heart Defects
- Congenital Heart Defects: Caring for Your Child
- Coronary Artery Disease: Should I Have an Angiogram?
- Triggers of Sudden Heart Failure
- Classification of Heart Failure
- Heart Failure: Tips for Easier Breathing
- Heart Failure: Avoiding Colds and Flu
- Heart Failure
- Helping Someone During a Panic Attack
- Aortic Aneurysm
- High Blood Pressure
- Coronary Artery Disease: Family History
- Angina
- Using Nitroglycerin for Angina
- Heartburn: Changing Your Eating Habits
- Angiotensin II receptor blockers (ARBs)
- Beta-blockers
- Heart Rhythm Problems: Diary of Symptoms
- Vagal Manoeuvres for Supraventricular Tachycardia (SVT)
- Electrical Cardioversion (Defibrillation) for a Fast Heart Rate
- Catheter Ablation for a Fast Heart Rate
- Supraventricular Tachycardia
- Home Blood Pressure Log
- Blood Pressure Screening
- Heart Block
- Electrical System of the Heart
- Heart Rhythm Problems and Driving
- Heart Rhythm Problems: Symptoms
- Resuming Sexual Activity After a Heart Attack
- Risk Factors for Coronary Artery Disease
- Pacemaker for Bradycardia
- SPECT Image of the Heart
- Heart Attack and Stroke in Women: Reducing Your Risk
- Ventricular Tachycardia
- Aspirin to Prevent Heart Attack and Stroke
- Temporal Artery Biopsy
- Emergency First Aid for Heatstroke
- Heartburn Symptom Record
- Heart Attack and Unstable Angina
- Congenital Heart Defects in Adults
- Monitoring and Medicines for Heart Failure
- Ventricular Assist Device (VAD) for Heart Failure
- Cardiac Output
- Heart Failure Symptoms
- Heart Failure: Less Common Symptoms
- Heart Failure With Reduced Ejection Fraction (Systolic Heart Failure)
- Heart Failure With Preserved Ejection Fraction (Diastolic Heart Failure)
- High-Output Heart Failure
- Right-Sided Heart Failure
- Heart Failure Complications
- How the Heart Works
- Coronary Arteries and Heart Function
- Heart Failure Types
- Enjoying Life When You Have Heart Failure
- Heart Failure: Tips for Caregivers
- Medicines to Prevent Abnormal Heart Rhythm in Heart Failure
- Cardiac Cachexia
- Heart Failure Stages
- Cardiac Rehabilitation Team
- Cardiac Rehabilitation: Emotional Health Benefits
- Ischemia
- Coronary Artery Disease: Roles of Different Doctors
- Coronary Artery Disease: Helping a Loved One
- Manage Stress for Your Heart
- Intermittent Claudication
- Peripheral Arterial Disease: Pulse and Blood Pressure Measurement
- Heart Failure and Sexual Activity
- Joan's Story: Coping With Depression and Anxiety From Heart Failure
- Rheumatic Fever and the Heart
- Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
- Acute Coronary Syndrome
- Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
- Heart Failure: Should I Get a Pacemaker ?
- Heart Failure: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- Heart Valve Disease
- Myxoma Tumours of the Heart
- Aortic Dissection
- Heart Attack and Stroke Risk Screening
- High Blood Pressure: Checking Your Blood Pressure at Home
- Hypertensive Emergency
- Stroke Rehabilitation
- Treatment for Stroke-Related Spasticity
- Driving a Car After a Stroke
- Heart Failure: Avoiding Medicines That Make Symptoms Worse
- Stroke Recovery: Coping With Eating Problems
- Heart Murmur
- High Blood Pressure: Should I Take Medicine?
- Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
- Tyrell's Story: Taking Pills for High Blood Pressure
- Stroke Prevention: Should I Have a Carotid Artery Procedure?
- Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?
- Stroke: Should I Move My Loved One Into Long-Term Care?
- Atrial Fibrillation: Should I Take an Anticoagulant to Prevent Stroke?
- Smoking and Coronary Artery Disease
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Hepatitis
- Hepatitis C: Your Risk for Cirrhosis
- Hepatitis E
- Hepatitis B Immune Globulin - Injection
- Heparin - Injection
- Fulminant Hepatitis
- Protect Yourself From Hepatitis A When Travelling
- Hepatitis A
- Viral Hepatitis
- Hepatitis C
- Hepatitis D
- Hepatitis B: How to Avoid Spreading the Virus
- Hepatitis B
- Hepatitis Panel
- Hepatitis B Treatment Recommendations
- Hepatitis B: Should I Be Tested?
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HIV
- HIV Infection
- HIV Viral Load
- HIV: Stages of Infection
- Ways HIV Cannot Be Spread
- HIV and Exercise
- HIV: Giving Support
- HIV: Tips for Caregivers to Avoid Infection
- HIV: Preventing Other Infections When You Have HIV
- HIV Home Care
- Antiretroviral medicines for HIV
- Resistance to HIV Medicines
- HIV: Preventing Infections
- HIV: Antiretroviral Therapy (ART)
- Opportunistic Infections in HIV
- HIV: Taking Antiretroviral Drugs
- HIV: Non-Progressors and HIV-Resistant People
- HIV Screening
- HIV and Weight Loss
- HIV and Fatigue
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Infectious Diseases
- Anthrax
- Avian Influenza
- Avoiding Infections in the Hospital
- Bacterial Infections of the Spine
- Bites and Stings: Flu-Like Symptoms
- Boric Acid for Vaginal Yeast Infection
- Caregiving: Reducing Germs and Infection in the Home
- Central Venous Catheter: Flushing
- Chickenpox (Varicella)
- Chickenpox: Preventing Skin Infections
- Chikungunya Fever
- Complicated Urinary Tract Infections
- Complications of Ear Infections
- Cranberry Juice and Urinary Tract Infections
- Dengue Fever
- Ear Infection: Should I Give My Child Antibiotics?
- Ear Infections
- Ebola or Marburg Virus Infection
- Ebola Virus Disease
- Enterovirus D68 (EV-D68)
- Fever or Chills, Age 11 and Younger
- Fever or Chills, Age 12 and Older
- Fever Seizures
- Fever Temperatures: Accuracy and Comparison
- Feverfew for Migraines
- Fifth Disease
- Flu: Signs of Bacterial Infection
- Fungal Nail Infections
- Giardiasis
- Hand-Foot-and-Mouth Disease
- Kissing Bugs
- Measles (Rubeola)
- Middle East Respiratory Syndrome (MERS)
- Molluscum Contagiosum
- Monkeypox
- Mononucleosis (Mono)
- Mononucleosis Complications
- Mumps
- Nail Infection: Should I Take Antifungal Pills?
- Neutropenia: Preventing Infections
- Non-Surgical Nail Removal for Fungal Nail Infections
- Noroviruses
- Pleurisy
- Pneumonia
- Preventing Tetanus Infections
- Pseudomonas Infection
- Recurrent Ear Infections and Persistent Effusion
- Recurrent Vaginal Yeast Infections
- Respiratory Syncytial Virus (RSV) Infection
- Rotavirus
- Rubella (German Measles)
- Scarlet Fever
- Sexually Transmitted Infections
- Sexually Transmitted Infections: Genital Examination for Men
- Sexually Transmitted Infections: Symptoms in Women
- Sexually Transmitted Infections: Treatment
- Shingles
- Smallpox
- Sore Throat and Other Throat Problems
- Staph Infection
- Strep Throat
- Symptoms of Pelvic Infection
- Thrush
- Tick Bites: Flu-Like Symptoms
- Tinea Versicolor
- Tuberculosis (TB)
- Tuberculosis Screening
- Urinary Tract Infections (UTIs) in Older Adults
- Vaginal Yeast Infection: Should I Treat It Myself?
- Vaginal Yeast Infections
- Valley Fever
- West Nile Virus
- Zika Virus
- Informed Health Decisions
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Injuries
- Trapped Finger, Toe, or Limb
- Blister Care
- Exercises for Heel Pain or Tightness
- Broken Toe
- Broken Nose (Nasal Fracture)
- Preventing Blisters
- Hip Fracture
- Medial Collateral Ligament (MCL) Injury
- Pressure Injuries From Scuba Diving
- Pressure Injuries: Stages
- Pressure Injuries: Prevention and Treatment
- Calf Muscle Injury
- Avulsion Fracture
- Lateral Collateral Ligament (LCL) Injury
- Posterior Cruciate Ligament (PCL) Injury
- Frozen or Stuck Tongue or Other Body Part
- Fifth Metatarsal Jones Fracture
- Animal and Human Bites
- Blisters
- Burns and Electric Shock
- Choking Rescue Procedure: Heimlich Manoeuvre
- Cold Temperature Exposure
- Cuts
- Ear Problems and Injuries, Age 11 and Younger
- Elbow Injuries
- Elbow Problems, Non-Injury
- Facial Injuries
- Facial Problems, Non-Injury
- Fish Hook Injuries
- Toe, Foot, and Ankle Injuries
- Groin Problems and Injuries
- Finger, Hand, and Wrist Injuries
- Anterior Cruciate Ligament (ACL) Injuries
- Safe Hand and Wrist Movements
- Physical Rehabilitation for ACL Injuries
- Marine Stings and Scrapes
- Mouth Problems, Non-Injury
- Nail Problems and Injuries
- Puncture Wounds
- Shoulder Problems and Injuries
- Removing Splinters
- Swallowed Button Disc Battery, Magnet, or Object With Lead
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Topic Overview
What is diabetic neuropathy?
Neuropathy means nerve disease or damage. Diabetic neuropathy is nerve damage caused by diabetes. People who have diabetes often have high blood sugar levels. Over time, high blood sugar levels can damage nerves throughout your body.
There are three kinds of diabetic neuropathy.
- Peripheral neuropathy is damage to peripheral nerves. These are the nerves that sense pain, touch, hot, and cold. They also affect movement and muscle strength. The nerves in the feet and lower legs are most often affected. This type of nerve damage can lead to serious foot problems. The damage usually gets worse slowly, over months or years.
- Autonomic neuropathy is damage to autonomic nerves. These nerves control things like your heartbeat, blood pressure, sweating, digestion, urination, and sexual function.
- Focal neuropathy affects just one nerve, usually in the wrist, thigh, or foot. It may also affect the nerves of your back and chest and those that control your eye muscles. This type of nerve damage usually happens suddenly.
What causes diabetic neuropathy?
Over time, high blood sugar levels from diabetes can damage nerves throughout your body. The higher your blood sugar levels, the more likely you are to have nerve damage. So controlling your blood sugar throughout your life is very important.
The older you get, and the longer you have diabetes, the more likely you are to have nerve damage. People who have diabetes who drink too much alcohol are also more likely to have nerve damage.
What are the symptoms?
Your symptoms will depend on which nerves are injured. You may not be able to feel pain, especially in your feet. This can lead to serious infections, because sores or other problems may not get treated.
When other parts of your body are affected, symptoms may include:
- Problems with digestion, such as bloating, belching, constipation, nausea and vomiting, diarrhea, and belly pain.
- Problems with body temperature, such as heavy sweating at night or when you eat certain foods. Some people may have reduced sweating, especially in their feet and legs.
- Problems with urination, such as finding it hard to tell when your bladder is full or finding it hard to empty your bladder completely.
- Sexual problems, such as erection problems in men and vaginal dryness in women.
- Heart and blood vessel problems, leading to poor circulation or low blood pressure. This may cause dizziness, weakness, or fainting when you stand or sit up from a reclining position.
- Trouble sensing when your blood sugar is low.
How is diabetic neuropathy diagnosed?
Your doctor will check how well you feel light touch and temperature and will test your strength and your reflexes. Tests such as electromyogram and nerve conduction studies may be done to confirm the diagnosis. You may need other tests to see which type of neuropathy you have and to help guide your treatment.
Doctors can't test for all types of nerve damage. So it's important to tell your doctor about any pain or weakness you feel. Also mention heavy sweating or dizziness and any changes in digestion, urination, and sexual function.
How is it treated?
Treatment involves keeping blood sugar levels in your target range. This will not cure the nerve damage, but it can help keep the damage from getting worse, and the pain might get better.
Other treatment depends on your symptoms:
- Pain may be treated with medicines.
- Digestive system problems or blood vessel problems may be treated with medicines.
- Blood pressure problems may be treated with medicines and by wearing support stockings (also called compression stockings).
- Sexual problems may be helped with medicines or devices to improve erections or with lubricating creams that help vaginal dryness.
- A splint or brace may be used for a pinched nerve.
When you have diabetes, you could have a sore or other foot problem without noticing it. Check your feet every day. An untreated problem on your foot can lead to a serious infection or even amputation.
Be clear with your doctor about what is helping you feel better and what is not. You and your doctor can work together to find the treatment that helps you the most.
Can diabetic neuropathy be prevented?
Keeping your blood sugar levels in your target range, set with your doctor, may help prevent neuropathy from ever developing. The best way to do this is by checking your blood sugar and adjusting your treatment. It is also important to get to and stay at a healthy weight by exercising and eating healthy foods.
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Symptoms
Diabetic neuropathy—especially peripheral neuropathy—initially may not cause any noticeable symptoms. If you have diabetes, it is important to have regular medical checkups to check for signs of neuropathy and treat problems before they become serious.
Symptoms of diabetic neuropathy may vary depending on the type of neuropathy you have.
Symptoms of peripheral neuropathy
Peripheral neuropathy tends to develop slowly over months or years. In general, symptoms may include:
- Reduced feeling or numbness in the feet.
- Over time, tightness, burning, shooting, or stabbing pain in the feet, hands, or other parts of the body. Bone and joint deformities can develop, especially in the feet (such as Charcot foot).
- Greatly reduced or greatly increased sensitivity to light touch or temperature.
- Weakness and loss of balance and coordination.
Symptoms of autonomic neuropathy
Autonomic neuropathy may affect digestion, the body's ability to regulate temperature, urination, sexual function, and heart and blood vessel function, including blood pressure. Symptoms may get worse during pregnancy. In general, symptoms may include:
- Frequent bloating, belching, constipation, heartburn, nausea and vomiting, diarrhea, and abdominal pain. These symptoms may point to gastroparesis, a condition that causes the stomach to empty much slower than normal.
- Extreme sweating of the torso, face, or neck at night or while eating certain foods, such as spicy foods and cheese. Some people may have reduced sweating, especially in their feet and legs.
- Trouble sensing when the bladder is full or problems emptying the bladder completely.
- Sexual problems, such as erection problems in men and vaginal dryness in women.
- Dizziness, weakness, or fainting when you stand or sit up from a reclining position (orthostatic hypotension).
- Trouble knowing when your blood sugar is low (hypoglycemia unawareness).
Symptoms of focal neuropathy
Symptoms of focal neuropathy usually appear suddenly. They may include:
- Pain, weakness, and motor problems in a single area of the body, such as a wrist, thigh, or foot. In cases of a compressed or pinched nerve, soreness and pain may develop more gradually over several weeks or months.
- Pain in and around one of your eyes, trouble moving an eye, and double vision. Focal neuropathy may sometimes affect the nerves that control your eye muscles.
Symptoms of focal neuropathy usually get better over time. But focal neuropathy may be permanent.
Examinations and Tests
A diagnosis of diabetic neuropathy is based largely on your symptoms, medical history, and physical examination. During a physical examination, your doctor may check how well you feel light touch, temperature, pain, vibration, and movement. Your doctor may also check your strength and reflexes. Electromyogram (EMG) and nerve conduction studies may be done to confirm a diagnosis. These tests measure how well and how quickly the nerves conduct electrical impulses. When nerve damage is present, the speed of nerve function slows.
Problems linked with autonomic neuropathy—which affects the nerves that control internal functions—can be hard to diagnose. When new symptoms develop, more testing may be needed to diagnose the problem, identify the cause, and guide treatment. For example, a study that measures how fast your stomach empties may be done if symptoms like bloating, indigestion, or vomiting suggest gastroparesis, a condition that causes the stomach to take too long to empty.
Nerve problems in people who have diabetes may be caused by other conditions, such as kidney disease, alcohol use disorder, or a vitamin B12 deficiency. A variety of laboratory tests (such as a complete blood count) may be used to screen for conditions other than diabetes that could be causing symptoms. Your symptoms and medical history will determine which tests are needed.
Early Detection
For some diseases, doctors can use screening tests to look for problems before you have any symptoms. But doctors can't test for all types of autonomic or focal neuropathy. So it is important to report to your doctor any pain, weakness, or motor problems you have. Also mention any changes in digestion, urination, sexual function, sweating, or dizziness. Your doctor will also look for signs of autonomic neuropathy during your physical examinations.
Diabetes Canada recommends that people who have diabetes see a doctor to examine their feet at least once a year and more often for those at high risk.footnote 1 Your doctor will look your feet for cracked or peeling skin, excessive or reduced sweating, blisters, calluses, ulcers, signs of infection, bone and joint abnormalities, and walking and balance. This examination can detect a loss of sensation in your feet, which can lead to more serious foot problems.
Treatment Overview
Good control of diabetes over time is the key to treating diabetic neuropathy. There is no cure for neuropathy, but keeping your blood sugar within a target range can reduce symptoms and prevent them from getting worse.
To help control your diabetes, eat food that is good for you and exercise. Controlling diabetes means maintaining blood sugar levels (A1c) within the target range. This will do more than anything else to help prevent diabetic neuropathy from getting worse.
Initial and ongoing treatment
Treatment for diabetic neuropathy depends on your symptoms and the type of neuropathy that you have. In general, treatment focuses on reducing current symptoms and preventing the condition from getting worse by keeping your blood sugar level within your target range. You can keep your blood sugar levels within the target range by taking your insulin or oral diabetes medicine as prescribed, checking your blood sugar levels, following your diet for diabetes, exercising, and seeing your doctor regularly.
Also, it is important to properly care for your feet when you have diabetic neuropathy. Diabetic neuropathy may cause a loss of feeling in your feet. It is possible for a sore or other foot problem to go unnoticed. Without proper foot care, an untreated foot sore can lead to a serious infection or possibly amputation.
It is also wise to maintain healthy habits such as seeing your doctor regularly, controlling your blood pressure, eating a balanced diet, exercising regularly, not smoking, and limiting or avoiding alcohol. Further treatment depends on the specific type of diabetic neuropathy that you have along with your current symptoms.
Peripheral neuropathy
Many people with peripheral neuropathy have mild to severe pain in specific parts of their bodies. Talk with your doctor about treatment that can reduce your pain and improve your physical functioning, mood, and mental well-being. Some people find these treatments helpful:
- Medicines such as pain relievers or creams to relieve pain. Prescription medicines often used to reduce pain from diabetic neuropathy may include medicines that are more commonly used to treat depression, such as tricyclic antidepressants and the antidepressant duloxetine hydrochloride, and medicines that control seizures, such as pregabalin and gabapentin. These medicines may be tried to reduce your pain even though you do not have depression or seizures.
- Complementary therapies such as acupuncture and biofeedback
- Physiotherapy such as exercises, stretching, and massage. If you are told to use heat or ice, be careful. Neuropathy can make it hard for you to feel changes in temperature.
- Transcutaneous electrical nerve stimulation (TENS), which is a type of therapy that reduces pain by applying brief pulses of electricity to nerve endings in the skin
Autonomic neuropathy
Autonomic neuropathy—which affects nerves that regulate internal functions—can affect digestion, urination, sweating, sexual function, blood pressure, and other involuntary body functions. Some symptoms of autonomic neuropathy can be hard to manage, but others respond well to treatment:
- Mild constipation. Eating small, frequent meals that are high in fibre and low in fat may help.
- Frequent diarrhea. Eating foods that are high in fibre may help. You may need medicines that slow the rate at which digested food and waste travel through the intestines, or you may need antibiotics such as amoxicillin, metronidazole, or tetracycline.
- Mild gastroparesis. This is a condition that causes the stomach to empty very slowly. It may get better if you eat small, frequent meals that are low in fibre and fat. Medicines that help the stomach empty more quickly may also be needed. Controlling blood sugar levels may reduce symptoms of gastroparesis.
- Abnormal sweating. If you sweat a lot, try to avoid intense heat and humidity. If you don't sweat enough, you can use moisturizers to help with dry or cracked skin. Drinking more water can prevent overheating. Try to avoid places that are very hot or very cold.
- Lack of awareness of low blood sugar level. This is also called hypoglycemia unawareness. You can adjust your insulin and allow your blood sugar levels to be a little bit higher than the target range. Usually it is recommended that you keep your A1c in a target range.
- Urinary problems. Urinary problems can be treated with antibiotics for urinary tract infections and medicines to improve bladder control.
- Sexual problems. Your doctor may suggest using medicines or devices to improve erections. Or you may need non-prescription lubricants and estrogen creams for vaginal dryness.
- Blood pressure problems. High blood pressure may be treated with angiotensin-converting enzyme (ACE) inhibitors, such as benazepril and enalapril. Low blood pressure can be treated with medicines and by wearing support stockings (also called compression stockings).
Treatment if the condition gets worse
If diabetic neuropathy gets worse, you may have serious problems such as severe gastroparesis, bladder infections, or foot problems. In addition to keeping your blood sugars in your target range and taking good care of your feet, you may need further treatment if diabetic neuropathy progresses.
Diabetic neuropathy is a major risk factor for foot infections or foot ulcers leading to amputation. It is possible to have permanent disfigurement in one or both of your feet (such as Charcot foot) from diabetic neuropathy. Surgery is sometimes needed to correct deformed joints that can result from Charcot foot.
Severe gastroparesis may require other treatment, such as medicines that empty the stomach more quickly or a feeding tube that is inserted into the stomach.
Severe bladder infections or other bladder problems, such as loss of control, may require further diagnostic testing and treatments such as medicines or surgery to improve bladder function.
Also, it is common to experience symptoms of depression with any chronic disease, such as diabetes or diabetic neuropathy. Seeking help for depression may improve your overall well-being and aid in the treatment of your condition.
What To Think About
No matter what you or your doctor try, you may not be pain-free. Be clear with your doctor about what is helping and what is not. You and your doctor can work together to find the right combination of medicine and other treatments to help you the most.
Related Information
References
Citations
- Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Foot care. Canadian Journal of Diabetes, 42(Suppl 1): S222–S227. DOI: 10.1016/j.jcjd.2017.10.020. Accessed October 15, 2018.
Other Works Consulted
- Brannagan TH (2010). Acquired neuropathies. In LP Rowland, TA Pedley, eds., Merritt's Neurology, 12th ed., chap. 134, pp. 832–833. Philadelphia: Lippincott Williams and Wilkins.
- Brownlee M, et al. (2011). Complications of diabetes mellitus. In S Melmed et al., eds., Williams Textbook of Endocrinology, 12th ed., pp. 1462–1551. Philadelphia: Saunders.
- Canadian Diabetes Association Clinical Practice Guidelines Expert Committee (2013). Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Canadian Journal of Diabetes, 37(Suppl 1). Also available online: http://guidelines.diabetes.ca.
- Freeman R (2010). Diabetic neuropathy. In RS Beaser, ed., Joslin's Diabetes Deskbook: A Guide for Primary Care Providers, 2nd ed., pp. 499–522. Boston, MA: Joslin Diabetes Center.
- Hunt DL (2011). Diabetes: Foot ulcers and amputations, search date September 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Masharani U, German MS (2011). Pancreatic hormones and diabetes mellitus. In DG Gardner, D Shoback, eds., Greenspan's Basic and Clinical Endocrinology, 9th ed., pp. 573–655. New York: McGraw-Hill.
- National Institute of Diabetes and Digestive and Kidney Diseases (2008). Diabetic Neuropathies: The Nerve Damage of Diabetes (NIH Publication No. 08–3185). Available online: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/neuropathies.pdf.
- Watson CPN (2011). Neuropathic pain. In C Repchinsky, ed., Therapeutic Choices, 6th ed., pp. 241–258. Ottawa: Canadian Pharmacists Association.
Credits
Current as of: July 28, 2021
Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Brian D. O'Brien MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Karin M. Lindholm DO - Neurology
Current as of: July 28, 2021
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Brian D. O'Brien MD - Internal Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Karin M. Lindholm DO - Neurology
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