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Pawleys Podiatry

(843) 235-0002

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  • Diabetic Peripheral Neuropathy

What is Diabetic Peripheral Neuropathy?
Diabetic neuropathy is nerve damage caused by diabetes. When it affects the arms, hands, legs and feet it 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.

 

Three different groups of nerves 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.

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, a leg, or even a life.

Causes
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 the nerves.

As diabetic peripheral neuropathy progresses, various nerves are affected. These damaged nerves can cause problems that encourage development of ulcers. For example:

  • Motor Neuropathy (Deformity)

    +

    Ill-fitting shoes

    +

    Sensory Neuropathy (numbness)

    =

    Ulcers (sores)

    Deformities (such as bunions or hammertoes) resulting from motor neuropathy may cause shoes to rub against toes, creating a sore. The numbness caused by sensory neuropathy can make the patient unaware that this is happening.
  • Because of numbness, a patient may not realize that he or she has stepped on a small object and cut the skin.
  • Cracked skin caused by autonomic neuropathy, combined with sensory neuropathy’s numbness and problems associated with motor neuropathy can lead to developing a sore.

Symptoms
Depending on the type(s) of nerves involved, one or more 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

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

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 painful 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.

Prevention
The patient plays a vital role in minimizing the risk of developing diabetic peripheral neuropathy and in preventing its possible consequences. Some important preventive measures include:

  • Keep blood sugar levels under control.
  • Wear well-fitting shoes to avoid getting sores.
  • Inspect your feet every day. If you notice any cuts, redness, blisters, or swelling, see your foot and ankle surgeon right away. This can prevent problems from becoming worse.
  • Visit your foot and ankle surgeon on a regular basis for an examination to help prevent the foot complications of diabetes.
  • Have 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.

  • Bone/Joint/Tendon
    • Accessory Navicular Syndrome
    • Achilles Tendon Rupture
    • Ankle
      • Ankle Arthritis
      • Ankle Fractures
      • Ankle Pain
      • Ankle Sprain
      • Swollen Ankles
      • Tarsal Coalition
      • Tarsal Tunnel Syndrome
      • Weak Ankles
    • Arch Pain
    • Arch Supports
    • Bone Healing
    • Bone Infection
    • Bone Tumors in the Foot
    • Brachymetatarsia
    • Bunions (Hallux Abducto Valgus)
    • Bursitis
    • Calcaneal Apophysitis (Sever's Disease)
    • Calf Pain
    • Capsulitis of the Second Toe
    • Cavus Foot (High-Arched Foot)
    • Charcot Foot
    • Chronic Ankle Instability
    • Clubfoot
    • Cold Feet
    • Common Disorders of the Achilles Tendon
    • Drop Foot
    • DVT (Deep Vein Thrombosis)
    • Extra Bones
    • Fallen Arches
    • Fifth Metatarsal Fracture
    • Flatfoot
      • Flatfoot-Adult Acquired
      • Flatfoot-Flexible
      • Flatfoot-Pediatric
    • Foot Arthritis
    • Foot Drop
    • Fracture
      • Foot Fracture
      • Fracture-Ankle
      • Fracture-Foot
      • Fractures of the Calcaneus (Heel Bone Fractures)
      • Fractures of the Fifth Metatarsal
      • Fracture-Toe
      • Jones Fracture
      • Stress Fracture in the Foot
      • Toe and Metatarsal Fractures (Broken Toes)
    • Gangrene
    • Gout
    • Haglund's Deformity
    • Hallux Rigidus
    • Hammertoes
    • Heel Pain (Plantar Fasciitis)
    • High-Arched Foot
    • Intermetatarsal Neuroma
    • Intoeing
    • Joint Pain in the Foot
    • Joint Swelling in the Foot
    • Lisfranc Injuries
    • Os Trigonum Syndrome
    • Osteoarthritis of the Foot and Ankle
    • Osteomyelitis (Bone Infection)
    • Osteopenia
    • Osteoporosis
    • Peroneal Tendon Injuries
    • Pigeon-toes
    • Posterior Tibial Tendon Dysfunction (PTTD)
    • R.I.C.E Protocol
    • Restless Legs
    • Rheumatoid Arthritis in the Foot and Ankle
    • Sesamoid Injuries in the Foot
    • Shin Splints
    • Swollen Feet
    • Synovitis
    • Tailor's Bunion
    • Talar Dome Lesion
    • Tingly Feet
    • Tired Feet
    • Toe Walking
    • Turf Toe
    • Varicose Veins
    • Webbed Toes
  • Nails and Skin
    • Athlete's Foot
    • Black Toenails
    • Callus
    • Contact Dermatitis
    • Corns
    • Cracked Heels
    • Dermatitis
    • Dry Heels
    • Eczema of the Foot
    • Foot Bumps
    • Foot Lumps
    • Foot Odor
    • Foot Rash
    • Frostbite
    • Fungal Nails
    • Ganglion Cyst
    • Heel Fissures
    • Inflammation: Acute
    • Ingrown Toenails
    • Malignant Melanoma of the Foot
    • Plantar Fibroma
    • Plantar Wart (Verruca Plantaris)
    • Pump Bump (Hallux Rigidus)
    • Puncture Wounds
    • Rash
    • Raynauds Phenomenon
    • Skin Cancer of the Foot and Ankle
    • Smelly Feet
    • Sweaty Feet
    • Thick Toenails
    • Warts
    • White Toenails
    • Wounds/Ulcers
    • Wounds-Puncture
    • Yellow Toenails
  • Diabetic Health
    • Diabetic Complications and Amputation Prevention
    • Diabetic Foot Care Guidelines
    • Diabetic Peripheral Neuropathy
    • Diabetic Shoes
    • MRSA Infection of the Foot
    • Peripheral Arterial Disease (P.A.D.)
    • Soft Tissue Biopsy
  • Fitness and Your Feet
    • Baseball Injuries to the Foot and Ankle
    • Basketball Injuries to the Foot and Ankle
    • Field Hockey Injuries to the Foot and Ankle
    • Football Injuries to the Foot and Ankle
    • Golf Injuries to the Foot and Ankle
    • Lacrosse Injuries to the Foot and Ankle
    • Rugby Injuries to the Foot and Ankle
    • Running and Track Injuries to the Foot and Ankle
    • Soccer Injuries to the Foot and Ankle
    • Softball Injuries to the Foot and Ankle
    • Tennis Injuries to the Foot and Ankle
    • Volleyball Injuries to the Foot and Ankle
  • Orthotics and Footwear
    • Custom Orthotic Devices
    • Orthotics
    • Shoe Inserts
  • Compartment Syndrome
  • Deep Vein Thrombosis (DVT)
  • Equinus
  • Instructions for Using Crutches
  • Staph Infections of the Foot

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