Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy is a form of nerve damage resulting from chronically high blood sugar and/or diabetes. Long-term high blood sugar (glucose) causes damage to the peripheral nerves throughout your body; most often diabetic peripheral neuropathy causes damages to the nerves in the legs and feet. Diabetic peripheral neuropathy is a fairly common and serious complication resulting from diabetes.
Causes and Risk Factors Contributing to Diabetic Peripheral Neuropathy
Researchers have determined that long-term damage from unregulated high blood sugar levels interferes with the nerves’ ability to function, eventually leading to diabetic peripheral neuropathy. In addition, a number of other factors related to this condition contribute to nerve damage, including autoimmune response caused by inflammation; genetic predisposition to nerve damage; and increased risk of infection caused by damage to the blood vessels and nerves stemming from smoking and/or alcohol abuse.
Between 60 and 70% of diabetics will develop peripheral neuropathy; the following risk factors increase the risk of nerve damage resulting from the condition:
- Uncontrolled blood sugar;
- Diabetes history, the longer a person has diabetes, the greater the risk of developing this condition;
- Kidney damage and disease;
- Being obese and or overweight, a body mass index over 24 increases one’s risk of diabetic peripheral neuropathy;
- Smoking, which reduces blood flow to legs and feet and causes damage to the peripheral nerves while also slowing the healing process.
Complications Stemming from Diabetic Peripheral Neuropathy
Left untreated, diabetic neuropathy can lead to a number of very serious health complications and conditions, including amputation of a toe, foot, or leg. As damage to nerves in the lower extremities increase in severity, wounds can become infected and turn to ulcers; these conditions can lead to tissue death and bone infection resulting in the need to amputate the affected appendage.
Symptoms
Diabetic peripheral neuropathy refers to the damage caused to the peripheral nerves of the extremities, including legs, feet, arms, and hands as a direct result of diabetes. An estimated 60 to 70% of those with diabetes will develop peripheral neuropathy.
It is important to note that the nerves of the peripheral system have unique and specific roles and functions, meaning that symptoms of diabetic peripheral neuropathy often depend on the specific types of nerves affected by the condition.
There are four types of diabetic neuropathy, with diabetic peripheral neuropathy being the most common form. Peripheral neuropathy starts in the feet and legs, the condition may develop in the arms and hands; symptoms of this condition often increase in intensity at night. Symptoms of diabetic peripheral neuropathy often include :
Numbness and decreased sensation to pain and/or temperature changes
Sensations of burning and/or tingling
Severe pains and/or sharp cramping
Increased sensitivity, leading to pain from slight of touch
Muscle weakness and/or paralysis
Slowing, or complete loss, of reflexes - most commonly occurring in the ankle
Loss of balance and coordination
Serious foot problems, including pain, ulcers, and infections
Diagnosis
Diabetic peripheral neuropathy is usually diagnosed through a physical exam, an assessment of patient’s symptoms, and a review of a patient’s medical history.
In addition to the physical evaluation, a physician may perform further tests designed to diagnose the condition, these tests might include a filament test, electromyography, nerve conduction studies, and autonomic testing.
Possible Treatments
Although diabetic peripheral neuropathy does not have a known cure, the condition can be slowed or even prevented through close management of blood sugar levels and commitment to a healthy lifestyle.
The key to preventing, managing, and even reversing diabetic peripheral neuropathy lies in keeping blood glucose levels in a consistent and targeted range. The American Diabetes Association recommends the following ranges:
- Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals
- Less than 180 mg/dL (10.0 mmol/L) two hours after meals
The most effective blood sugar range will be developed and monitored by the physician and after considering a number of factors.
For those diagnosed with diabetic peripheral neuropathy, the goals of treatment include:
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