We recently received an email about the article Diabetes Type 2 Overview.  She asked,  what is diabetic neuropathy?

First off, what is neuropathy?   It is a general term used to describe disorders of the nerves.

Then, what is diabetic peripheral neuropathy?

Diabetic neuropathy is due to high glucose in the blood that leads to nerve damage.  The damage can interrupt the signal traveling from a part of the body (ie foot) to the spinal cord and brain.   The damage can lead to the “pins and needles” feeling, pain and numbness.

People with diabetes also have a higher risk of infection -add this to a numb area on the foot and you have the makings for a serious infection.  Which is why foot care is a big deal for patients with diabetes.  I always tell this story when someone says, “I can deal with some tingling and numbness, what’s the big deal?”

When I was working in the Diabetes Clinic, I met Mr. B.  He had diabetes for many years.  He never really changed his eating/exercise habits and didn’t really keep an eye on his blood sugar.  We discussed some medicine and he started it- begrudgingly.  At this point Mr. B had a little non-painful peripheral neuropathy (just some numbness around the toes).  We did a full foot exam and talked about him (or someone else) checking the bottom of his feet everyday. 

Mr.  B. missed a few appointments over the summer (he was visiting his grandkids).  While away, Mr. B. stepped on a sharp stone -it made a small puncture on the pad of his big toe.  He didn’t feel it because of the numbness.  Fastforward 8 weeks,  Mr. B. comes in for his appointment with great stories about the grandkids.  We do a foot exam, Mr. B. has a serious infection and his right toe is amputated within a few days.

I asked Mr. B. about the foot exams and he said, he thought it was silly and was embarrassed to ask someone else to look at his feet because sometimes he has trouble seeing the bottom of his feet.

What is it with infections being so serious in people with diabetes?  People with diabetes get infections more easily, heal slower and often don’t feel the warning signs due to neuropathy.

Number 1 way of avoiding diabetic peripheral neuropathy?  Controlled blood sugar levels!

Once a patient has diabetic peripheral neuropathy…

1.  Controlled blood sugars can slow the progression and may actually reverse some of the damage done.

2.  Foot Care –this includes regular foot examines with a medical professional and checking the bottom of the feet and between the toes daily -for dry, cracked skin, calluses and early signs of infection.  I am, as most healthcare people are, very intense about foot care.  Even wearing socks so that the seam rubs the foot can lead to an infection!

3. Medications –there are no medications to specifically treat peripheral neuropathy.  There are drugs that can help control blood sugar and then there are drugs that can help with the pain caused by neuropathy.

I will go into the medicines used to treat pain associated with peripheral neuropathy in the next article.

For now, there you have it -a diabetic peripheral neuropathy overview.

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