Diabetic Peripheral Neuropathy Overview and Treatment

What Diabetic Peripheral Neuropathy?

Peripheral neuropathy is nerve damage affecting the arms, hands, legs or feet.  Peripheral neuropathy is most commonly seen in people with diabetes.  Its is also referred to as diabetic peripheral neuropathy.

Three different groups of nerves can be affected by peripheral neuropathy:

  • Sensory nerves: enable people to feel pain, temperature, and other sensations
  • Motor nerves:  control the muscles and gives them their strength and muscle tone
  • Autonomic nerves: allow the body to perform certain involuntary functions, such as sweating.

Peripheral neuropathy is not a sudden disease unless there is trauma involved.  It is usually slow and worsens with time.  Sometimes patients have this condition long before they are diagnosed with diabetes or other systemic diseases.

The biggest risk for patients with peripheral neuropathy is complete loss of sensation and development of foot ulcers (sores).  Since patients have no sensation they can develop a blister which may become an ulcer and ultimately become infected.  This is a serious complication in diabetics, immunocompromised patients and in patients with peripheral arterial disease (PAD), which can ultimately lead to life threatening infections and limb loss (amputations)

What are Some Causes?

There are many causes of peripheral neuropathy.  Here are the most common ones:

  • Diabetes (diabetic peripheral neuropathy)
  • Trauma
  • Syphilis
  • Radiculopathy (spinal problems)
  • Alcoholisms
  • Vitamin B deficiency
  • Exposure to certain toxic chemical
  • Chemotherapy medications
  • The use of some medications can also lead to peripheral neuropathy

Symptoms of Diabetic Peripheral Neuropathy

This depends on the type of nerve that is affected. Patients with peripheral neuropathy may experience one or more of the following symptoms.

For sensory neuropathy:

  • Numbness or tingling
  • Sharp pain
  • burning feet
  • pins and needles sensation
  • having crawling sensation
  • hot / cold temperature change

For motor neuropathy:

  • Muscle weakness
  • Loss of muscle tone
  • Loss of balance

For autonomic neuropathy:

  • Dry feet
  • Cracked skin

Diagnosis of Diabetic Peripheral Neuropathy

To diagnose peripheral neuropathy, your foot and ankle specialist will obtain the patient’s history of symptoms and may perform simple in-office tests.  These clinical evaluations may include the patient’s:

  • Reflexes
  • Strength
  • Sensation to light touch
  • Vibratory sensation
  •  Nerve Conduction Velocity (NCV)

Conservative Treatment of Diabetic Peripheral Neuropathy

This all depends on the underlying cause of the peripheral neuropathy.

  • In diabetic patients, the control of their blood sugar is the key
  • Topical ointments
  • Physical therapy
  • Medications