DIABETIC NEUROPATHY

Diabetic Neuropathy is nerve damage caused by diabetes. If the damage affects the arms, hands, legs, or feet, it is known as diabetic peripheral neuropathy. Neuropathy is one of the most common complications of diabetes, occurring in up to 50% of diabetics, despite controlling blood sugar. Once it occurs, it almost always gets worse without treatment. Three different nerve groups can be affected by diabetic neuropathy:

Sensory nerves, which enable people to feel pain, temperature, and other sensations
Motor nerves, which control the muscles and give them their strength and tone
Autonomic nerves, which allow the body to perform certain involuntary functions, such as sweating.

Click image for enlarged version

Diabetic peripheral neuropathy develops slowly over time and worsens as the condition progresses. Patients may have the condition for a long time before they are diagnosed with diabetes. Patients who have had diabetes for several years may have an increased likelihood of having diabetic neuropathy.

Diabetic neuropathy typically affects the feet first and then the hands. The first symptoms are usually sensory changes, such as numbness or tingling in the toes. The symptoms may come and go, but eventually they become constant. Over a long period of time, the patient may experience such a loss of sensation that they may not feel how tight their shoes are, know whether the bath water is hot or cold, or whether or not an injury has occurred to their feet.

Patients with the loss of sensory nerves due to diabetic neuropathy are prone to developing skin ulcers and open sores that can become infected and not heal. This is a serious diabetic complication that could lead to the loss of a foot, leg, or life.

CAUSES OF DIABETIC NEUROPATHY

The nerve damage of diabetic peripheral neuropathy occurs more commonly in patients with poorly managed diabetes. However, even diabetic patients who have excellent blood sugar control can develop the condition.

SYMPTOMS OF DIABETIC PERIPHERAL NEUROPATHY

For sensory neuropathy:

Numbness or tingling in the feet
Pain or discomfort in the feet or legs, including prickly, sharp pain or burning feet

For motor neuropathy:

Muscle weakness and loss of muscle tone in the feet and lower legs
Loss of balance
Changes in foot shape that can lead to areas of increased pressure

For autonomic neuropathy:

Dry feet
Cracked skin

DIABETIC NEUROPATHY PREVENTION

There are several important preventive measures in order to minimize the risk of developing diabetic peripheral neuropathy, which include:

Keeping blood sugar levels under control.
Wearing well-fitting shoes to avoid getting sores.
Inspecting your feet every day. If you notice any cuts, redness, blisters, or swelling, see your foot and ankle surgeon right away.
Visiting your foot and ankle surgeon on a regular basis for an examination to help prevent the foot complications of diabetes.
Scheduling periodic visits with your primary care physician or endocrinologist. The foot and ankle surgeon works together with these and other providers to prevent and treat complications from diabetes.

TESTING AND TREATMENT

New testing and treatment has revolutionized care for diabetic neuropathy. Until now, the primary methods of treatment have included the rigorous control of blood sugar levels, meticulous care of the feet, and use of pain medication.

New testing procedures such as Sensory Testing (QST): Neurosensory and Motor Testing (NMT) will tell the doctor the stage of a person’s neuropathy in order to recommend the appropriate treatment. It also accurately diagnoses conditions with similar symptoms to neuropathy.

Some patients may qualify for Peripheral Nerve Decompression Surgery. North Texas Foot & Ankle Podiatrist, Dr. Ronica Holcombe, is trained in performing this innovative procedure.

If you believe you may be at risk for diabetic neuropathy or are exhibiting symptoms of the condition, please contact North Texas Foot & Ankle at (214)574-9255 to schedule an appointment.