What is Diabetic Peripheral Neuropathy?
 
Diabetic neuropathy is nerve damage caused by diabetes.  The type of neuropathy occurring in the arms, hands, legs and feet is known as diabetic peripheral neuropathy.  Diabetic Peripheral Neuropathy is different from peripheral arterial disease (poor circulation), which affects the blood vessels rather than the nerves. 
 
Diabetic peripheral neuropathy doesn't emerge overnight- instead, it usually develops slowly and worsens over time.  Some patients have this condition long before they are diagnosed with diabetes.  Having diabetes for several years may increase the likelihood of having diabetic neuropathy.
 
The loss of sensation and other problems associated with nerve damage make a patient prone to developing skin ulcers (open sores) that can become infected and may not heal.  This serious complication of diabetes can lead to loss of a foot, leg or even a life.
 
Signs and Symptoms (Bold and underlined) Depending on the type(s) of nerves involved, one or more signs and symptoms may be present in 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 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

 
What Causes Diabetic Peripheral Neuropathy? (Bold and underlined) The nerve damage that characterizes diabetic peripheral neuropathy is more common in patients with poorly managed diabetes.  However, even diabetic patients who have excellent blood sugar (glucose) control can develop diabetic neuropathy.  There are several theories as to why this occurs, including the possibilities that high blood glucose or constricted blood vessels produce damage to nerves.
 
Diagnosis
To diagnose diabetic peripheral neuropathy, the foot and ankle surgeon will obtain the patient's history of symptoms and will perform simple in-office tests on the feet and legs.  This evaluation may include assessment of the patient's reflexes, ability to feel light touch, and ability to feel vibration.  In some cases, additional neurologic tests may be ordered.
 
Treatment
First and foremost, treatment of diabetic peripheral neuropathy centers on control of the patient's blood sugar level.  In addition, various options are used to treat the symptoms.  Medications are available to help relieve specific symptoms, such as tingling or burning.  Sometimes a combination of different medications is used.  In some cases, the patient may also undergo physical therapy to help reduce balance problems or other symptoms.