Diabetic neuropathy is nerve damage caused by diabetes. When it affects the arms, hands, legs, and feet, it is known as diabetic peripheral neuropathy. This condition is different from peripheral arterial disease (poor circulation), which affects the blood vessels rather than the nerves.
Three different groups of nerves can be affected:
Diabetic peripheral neuropathy usually develops slowly and worsens over time. You may have this condition long before you are diagnosed with diabetes. Having diabetes for several years may increase the probability of having diabetic neuropathy. The loss of sensation and other problems associated with nerve damage make you prone to developing skin ulcers (open sores) that can become infected and may not heal. This serious complication of diabetes can lead to the loss of your foot, leg or even your life.
The risk of nerve damage specific to diabetic peripheral neuropathy is much higher if your diabetes is managed poorly. However, even if you have excellent blood sugar control, the risk is high. There are several theories as to why this occurs, including the possibility that high blood glucose or constricted blood vessels may damage your nerves.
As diabetic peripheral neuropathy progresses, various nerves are affected. These damaged nerves may cause problems that encourage the development of ulcers.
Depending on the type(s) of nerves involved, several symptoms may be present:
For sensory neuropathy:
For motor neuropathy:
For autonomic neuropathy:
To diagnose diabetic peripheral neuropathy, we will obtain the history of your symptoms and perform some simple in-office tests on the feet and legs. This evaluation may include assessment of your ability to feel light touch and your ability to feel vibration. In some cases, additional neurologic tests may be performed.
Medications will be provided to help relieve specific symptoms, such as tingling or burning. Sometimes, a combination of different medications is prescribed. You may need to undergo some physical therapy to help reduce balance problems or other symptoms.