Diabetic Peripheral Neuropathy

What is Diabetic Peripheral Neuropathy?
Simply put, diabetic peripheral neuropathy is nerve damage caused by diabetes that occurs in the extremities (arms, hands, legs, and feet.) Three different types of nerves can be affected by diabetic neuropathy: Sensory (feeling, pain, temperature, etc) Motor (nerves that control muscles) and Autonomic (Involuntary functions, like sweating)
Diabetic peripheral neuropathy is a slow-progressing condition, with some patients having it for years before they are even diagnosed with diabetes. 
Additionally, the loss of sensation the neuropathy causes make patients more prone to developing skin ulcers (open sores) that can become infected and might not heal. As you can imagine, this is a serious issue, one that can take a foot, a limb, or even a life.

Signs and Symptoms

As stated before, diabetic peripheral neuropathy can affect different kinds of nerves. As such, there can be many different signs and symptoms:

  1. For sensory neuropathy
    • Numbness or tingling in the feet
    • Pain or discomfort in the feet or legs, like a prickly, sharp pain or a burning sensation
  2. For motor neuropathy
    • Muscle weakness and loss of muscle tone in the feet and lower legs
    • Loss of balance
    • Changes in the shape of your foot that can lead to areas of increased pressure
  3. For autonomic neuropathy
    • Dry feet
    • Cracked skin

In order to diagnose this condition, your podiatrist will go over your history of symptoms and will perform some simple tests on your feet and legs, including your reflexes, ability to feel light touch, and ability to sense vibration. In some cases, your doctor may order addition neurologic tests as well. 

What Causes This Condition?
Typically patients with poorly managed diabetes are more likely to develop diabetic peripheral neuropathy, but even patients who manage their diabetes well can develop it. There are some theories that high blood sugar or constricted blood pressure produces damage to the nerves.