What Is Diabetic Peripheral Neuropathy?
Diabetic peripheral neuropathy is a condition characterized by nerve damage caused by diabetes. It primarily affects the arms, hands, legs, and feet, and distinguishes itself from peripheral arterial disease, which pertains to issues with blood vessels rather than nerves.
This condition targets three distinct categories of nerves:
- Sensory nerves are responsible for transmitting sensations like pain, temperature, and other sensory inputs.
- Motor nerves, govern muscle control, strength, and tone.
- Autonomic nerves, facilitate involuntary bodily functions such as sweating.
Diabetic peripheral neuropathy doesn’t manifest suddenly; instead, it tends to develop gradually, worsening over time. Some individuals may have this condition even before a diabetes diagnosis, and prolonged diabetes duration heightens the risk. The nerve damage leads to a loss of sensation and other issues that make patients susceptible to skin ulcers (open sores) that may become infected and difficult to heal. In severe cases, this complication can result in the amputation of a foot or leg or even pose a threat to one’s life.
Causes
The Nerve damage associated with diabetic peripheral neuropathy is more prevalent in individuals with poorly managed diabetes. Nevertheless, even those with well-controlled blood sugar levels can develop this condition. Several theories seek to explain its occurrence, including the possibility that elevated blood glucose or constricted blood vessels contribute to nerve damage.
As diabetic peripheral neuropathy progresses, various nerves become affected, leading to problems that promote ulcer development. For instance:
- Motor neuropathy may result in deformities like bunions or hammertoes, causing shoes to rub against toes, and potentially creating sores. The numbness from sensory neuropathy can make patients unaware of this issue.
- Sensory neuropathy can cause a patient not to realize they’ve stepped on a small object, leading to skin cuts.
- Cracked skin, stemming from autonomic neuropathy, combined with sensory neuropathy’s numbness and motor neuropathy-related issues, can foster sore development.
Symptoms
The symptoms of diabetic peripheral neuropathy vary based on the nerves involved:
Diabetic For sensory neuropathy:
- Numbness or tingling in the feet.
- Pain or discomfort in the feet or legs, which can include sensations like prickly, sharp pain or burning.
For motor neuropathy:
- Muscle weakness and loss of muscle tone in the feet and lower legs.
- Loss of balance.
- Changes in foot shape may result in areas of increased pressure.
For autonomic neuropathy:
- Dry feet.
- Cracked skin.
Diagnosis
To diagnose diabetic peripheral neuropathy, a foot and ankle surgeon will take a detailed history of the patient’s symptoms and perform in-office tests on the feet and legs. This evaluation may encompass assessing reflexes, sensitivity to light touch, and the ability to feel vibrations. In some cases, additional neurologic tests may be ordered.
Treatment
The primary focus of diabetic peripheral neuropathy treatment revolves around controlling the patient’s blood sugar levels. Additionally, various treatment options are employed to alleviate painful symptoms. Medications are available to address specific symptoms like tingling or burning, and sometimes a combination of medications is utilized. In certain situations, healthcare professionals may recommend physical therapy to alleviate balance issues or other symptoms.
Prevention
Patients can actively participate in minimizing the risk of developing diabetic peripheral neuropathy and averting its potential consequences through several preventive measures, including:
- Maintaining well-controlled blood sugar levels.
- Wearing well-fitting shoes to prevent sores.
- Daily foot inspections to identify cuts, redness, blisters, or swelling. A foot and ankle surgeon should promptly address any anomalies to prevent complications.
- Regular visits to a foot and ankle surgeon for examinations to proactively manage diabetes-related foot complications.
- Periodic consultations with a primary care physician or endocrinologist, who works collaboratively with the foot and ankle surgeon and other healthcare providers to prevent and address diabetes-related complications.
