What is Diabetic Neuropathy?

Diabetic neuropathy is a serious diabetes complication that may affect as many as 50% of people with diabetes. But you can often prevent diabetic neuropathy or slow its progress with consistent blood sugar management and a healthy lifestyle.

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Diabetic neuropathy is a form of nerve damage that commonly affects individuals with diabetes, particularly impacting the nerves in the feet and legs. In its early stages, diabetic neuropathy may not show obvious signs or symptoms.

As the damage progresses over time , individuals with diabetes may experience sensations such as burning pain, tingling, and a loss of tactile sensation in the feet and hands. This reduced sensation poses a risk, as injuries like cuts, blisters, or ingrown toenails may go unnoticed, leading to potential complications.

If individuals have unaddressed wounds, it can fester and develop an infection which can spread rapidly, leading to serious conditions such as a gangrene. Gangrene is a condition that may lead to life-threatening complications like sepsis, a severe blood infection. Given the impaired ability of diabetic patients' bodies to combat infections due to elevated blood sugar levels, there is an increased risk of amputation of the affected limb in cases of severe complications.

Types of Neuropathy

Neuropathy can be categorised into four main types:

  • Peripheral symmetric neuropathy: This primarily affects the nerves in the feet before progressing to the hands, representing the most common form of diabetic neuropathy.
  • Autonomic neuropathy: This impacts the nerves controlling involuntary bodily functions like digestion, urination, and heart rate.
  • Thoracic and lumbar root, or proximal neuropathy: This damages nerves along specific distributions, such as the chest wall or legs.
  • Mononeuropathy (focal neuropathy): This targets a single individual nerve, resulting in localised pain, loss of movement, or numbness.

Patients with diabetes may experience multiple types of neuropathy at the same time, with peripheral neuropathy and mononeuropathy being the most commonly observed forms in diabetic podiatric cases.

How Do Podiatrists Manage Diabetic Neuropathy?

While there is currently no cure for diabetic neuropathy, podiatrists employ a range of therapies aimed at slowing down its progression, addressing secondary conditions and alleviating pain. Individual responses to these interventions may vary based on factors like glucose control, vascular supply, and the extent of nerve deterioration.

Your podiatrist will conduct recurrent, comprehensive diabetic foot examinations to monitor sensations and blood flow to the feet, ensuring timely intervention if deterioration is observed. They will also check for any emerging secondary conditions.

Podiatric solutions for diabetic neuropathy include:

  • Preservation of Foot Shape and Function: Custom foot orthotics or ankle-foot orthotics (AFOs) are made to maintain the shape and function of the feet, reducing fall risk and preventing deformation and collapse in diabetic feet. This facilitates patient mobility and activity.
  • In-Clinic Therapies: Utilising advanced technologies like Super Inductive System (SIS) and Extracorporeal Magneto Transduction Therapy (EMTT) during in-clinic sessions. These therapies aim to reduce tingling, numbness, and burning sensations while enhancing local blood supply.
  • Prevention and Wellness Management: Establishing a comprehensive prevention and wellness plan that incorporates meticulous skin and nail care. Specialised wound care is important to minimise the risk of limb amputation.

Through these targeted interventions, podiatrists strive to enhance the overall well-being of individuals with diabetic neuropathy, addressing not only the symptoms but also the underlying factors contributing to the condition.

Preventive measures of diabetic neuropathy

Effectively managing diabetic neuropathy involves several key components:

  1. Blood Sugar Management: Individuals with diabetes must prioritise the management of their blood sugar levels to reduce the risk of developing diabetic neuropathy.
  2. Regular Monitoring: Consistent monitoring of blood sugar levels, as well as regular check-ups with healthcare professionals, is essential for early detection and intervention.
  3. Medication Adherence: Strict adherence to prescribed medications, including those aimed at managing diabetes, is crucial to maintaining stable blood sugar levels.
  4. Healthy Lifestyle: Adopting a healthy lifestyle, which includes a balanced diet, regular exercise, and avoiding harmful habits like smoking, contributes to overall diabetes management and helps prevent complications such as neuropathy.
  5. Preventive Foot Care: Individuals with diabetes should prioritise foot care practices to prevent complications related to neuropathy. This includes regular inspection of the feet, proper hygiene, and avoiding activities that may lead to foot injuries.
  6. Prompt Medical Attention: If symptoms of neuropathy, such as tingling, numbness, or pain in the feet, arise, seeking prompt medical attention and podiatric care is crucial. Early intervention can help manage the condition and prevent further complications.

By incorporating these measures into their daily lives, individuals with diabetes can actively contribute to the effective management of diabetic neuropathy and reduce the risk of associated complications.

Prevention is key to managing diabetes. Diabetic patients with high risks should schedule podiatrist appointments every 3 to 6 months to promptly address any emerging foot abnormalities. For those at a lower risk, an annual visit is recommended, provided there are no significant concerns related to their feet and lower limbs. Regular podiatric check-ups play a crucial role in early detection, intervention, and the overall wellness of individuals with diabetes.

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Common Symptoms

Numbness in the feet and hands in a “stocking-glove” distribution
Abnormal or altered sensation in hands or feet
Constant pain in the extremities
Loss of balance
Difficulty walking without wobbling
Loss of muscle tone in the hands and feet
Burning and tingling sensations

How It Looks Like

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Good job guys! After the minor accident on my toe nail, it has healed 100%. I was so qorried as i am diabetic for 15 years. Now i still have my right big toe is ok now. Execllent job guys and the peripherals provided for home care is top notch from East Coast podiatory.

Wiryadi Hamidon

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An ankle specialist, such as a podiatrist, will be able to perform a thorough foot assessment using diagnostic tools, such as a musculoskeletal diagnostic ultrasound to determine the source of your ankle pain. If surgery is required, your podiatrist will refer you to a trusted foot and ankle doctor for surgical solutions.

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