Diabetic Peripheral Neuropathy

Definition: damage to the nerves outside of the brain and spinal cord (peripheral nervous system) that causes pain, numbness, tingling and/or muscle weakness in the extremities (feet and legs, hands and arms)

Medical terminology: Diabetic Peripheral Neuropathy

 

What is Diabetic Peripheral Neuropathy?

Diabetic neuropathy is nerve damage caused by diabetes. Peripheral neuropathy describes damage to the nerves outside of the brain and spinal cord, therefore the arms, hands, legs and feet. Diabetic peripheral neuropathy describes nerve damage to the peripheral nervous system as a complication of diabetes (high blood sugar levels).

Diabetic neuropathy affects 3 different groups of nerves

Autonomic nerves – Controls ‘involuntary’ actions of the body such as heart rate, digestion, sweating
Sensory nerves – Receive sensory signals that allow the body to feel pain, temperature and other sensations
Motor nerves – Controls muscle contraction and relaxation, giving them their strength and muscle tone

What are the symptoms of Diabetic Peripheral Neuropathy?

Symptoms often develop slowly over several years. Having diabetes for several years may increase your risk of developing nerve damage. Most of the time symptoms do not occur until many years after being diagnosed with diabetes.

Diabetic neuropathy can lead to serious, life threatening complications. Loss of feeling in the feet, due to sensory nerve damage, can increase a person’s chance to injury of their foot without knowing which can lead to an infection that could even progress to an amputation or even worse, death.

Several different types of nerves can be affected by diabetic peripheral neuropathy therefore one or more symptoms may be present.

For autonomic neuropathy

  • Dry, cracked skin
  • Excessive sweating
  • Heartburn and bloating
  • Feeling full after eating a small amount of food

For sensory neuropathy

  • Tingling or burning in the arms and legs
  • Numbing or loss of feeling in the arms and legs
  • Sensations often starts in your toes and feet
  • Deep pain in the feet or legs

For motor neuropathy

  • clawed toes due to muscle loss in toes
  • problems maintaining balance
  • muscle weakness, loss of muscle tone
  • diminished or lack of reflexes

 

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What causes Diabetic Peripheral Neuropathy?

Diabetic peripheral neuropathy is commonly seen in patients with poorly managed diabetes. Peripheral nerve damage may also be seen in patients with well managed diabetes. It has been proposed that nerve damage may be caused by high blood sugar levels and decreased blood flow.

How do you diagnose diabetic peripheral neuropathy?

A foot specialist, chiropodist or podiatrist, can diagnose diabetic peripheral neuropathy by obtaining a thorough patient history and history of symptoms as well as performing a comprehensive diabetic foot exam.

This in-office exam consists of a skin examination of the feet and legs, assessment of the patient’s ability to feel light touch and vibration and testing the patient’s reflexes. If necessary, additional neurological tests may be ordered through your family physician.

The first step in treating diabetic peripheral neuropathy is controlling your blood sugar levels. Well managed diabetes can help reduce many symptoms associated with diabetic peripheral neuropathy.

Medications are available by prescription from your family physician to help relieve some symptoms such as tingling or burning.

Some physical therapy, such as laser therapy or ultrasound, may help reduce some of the symptoms associated with diabetic neuropathy.

Can I prevent diabetic peripheral neuropathy?

There is no sure way to prevent diabetic peripheral neuropathy or its associated complications but there are a few ways to minimize the risk of development.

  • Monitoring and controlling blood sugar levels
  • Taking your diabetic medication on a regular basis
  • Seeing a foot specialist once or twice a year to conduct a comprehensive diabetic foot exam
  • Checking your feet daily to ensure no cuts, open sores or any signs of infection (red, hot and swollen)
  • Checking your shoes before wearing them to ensure no foreign objects, such as pebbles or a piece of glass, are inside that can harm your foot