East Coast Podiatry
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Last Updated: 12 Nov 2021

Diabetic Neuropathy

Diabetic neuropathy is a complication of diabetes that results in damage to the nervous system. Nerves are essential to a functioning body as they control sensation, movement, and unconscious movements like breathing and heartbeat regulation. Nerve damage in any area of the body causes the loss or reduction of control signals and can get progressively worse over time.

How Does Diabetic Neuropathy Affect Me?

Early stages of nerve damage may not have any obvious signs or symptoms. As the damage progresses, a person suffering from diabetes may experience burning pain, tingling sensations, a loss of tactile sensation in the feet and hands. Due to this loss of sensation, any injury sustained (i.e. a cut on the foot, development of a blister, an inflamed ingrown toenail, etc.) may not be noticed in time.

An untreated wound can fester and develop an infection that can spread quickly, leading to extensive tissue death (gangrene). This condition is life-threatening if sepsis develops, leaving diabetic patients to fight for their life or face amputation of the affected limb.

Neuropathy falls into four main categories:

  • Peripheral symmetric neuropathy: This affects the nerves in the feet first, and then the hands. It is the most common form of diabetic neuropathy.
  • Autonomic neuropathy: This occurs in the nerves that control involuntary body functions such as digestion, urination, and heart rate.
  • Thoracic and lumbar root, or proximal neuropathy: This damages nerves along a specific distribution such as the chest wall or legs.
  • Mononeuropathy: This affects a single individual nerve, resulting in pain in a localised area, loss of movement, or numbness.

Patients can suffer from multiple forms of neuropathy at the same time. Peripheral neuropathy and mononeuropathy are the most common forms of neuropathy in diabetic patients that are seen and treated by podiatrists.

What Are The Symptoms of Diabetic Neuropathy?

Symptoms of diabetic neuropathy build up over time, and commonly affect the feet and lower legs first, such as:

  • 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
  • Inability to feel differences in temperature or physical injuries in the limb
  • Tingling or burning sensations radiating from the toes to the ankles (then up the legs over time)
  • Bone deformity or foot collapse (Charcot arthropathy/ diabetic foot deformity)

Diabetic neuropathy worsens with time without the proper regulation of lifestyle choices such as reducing sugar and fat intake. Patients that do not develop any abnormal pains will still face a greater risk of falls if the early signs of diabetic neuropathy such as impaired balance and loss of sensation in the outer extremities are not addressed.

How Do Podiatrists Treat Diabetic Neuropathy?

As there is currently no cure for diabetic neuropathy, the main goals of treatment will be to slow progression, solve any secondary conditions, and relieve pain. Patients find that dedicated and targeted treatment methods can reverse damage and are useful in re-establishing sensations. However, this can vary depending on factors such as glucose control, vascular supply, and the degree of nerve deterioration at commencement of treatment.

Your podiatrist will carry out recurrent comprehensive diabetic foot-specific examinations to ensure sensation and blood flow to the feet are not in rapid decline. They will also take care to check for the presence of any subsequent secondary conditions.

Treatment options for diabetic neuropathy include:

  • Preserving the shape and function of the feet, reducing fall risk, and preventing the deformation and collapse of diabetic feet with custom foot orthotics or ankle foot orthotics (AFOs). This helps patients remain active and mobile.
  • In-clinic treatment with Super Inductive System (SIS) and Extracorporeal Magnetotransduction Therapy (EMTT) to reduce the tingling, numbness, and burning sensations while increasing localised blood supply.
  • A prevention and wellness treatment plan which includes skin, nail, and specialised wound care to help the patient avoid limb amputation as much as possible.

How Do I Prevent Diabetic Neuropathy?

Lifestyle changes

  • Weight management

    Maintaining a healthy weight decreases the occurrence of diabetic symptoms and makes it easier to control blood sugar levels. This greatly reduces the risk of a diabetic person developing neuropathy or other complications.

  • Quit smoking

    Smoking damages blood vessels and impacts blood flow in the body, affecting various body parts. It also raises blood glucose levels, makes it harder to control blood sugar, and increases the likelihood of secondary conditions such as heart disease, eye problems, or stroke.

Maintain blood sugar level

The risk for developing diabetic neuropathy increases the longer an individual has diabetes. Take care to keep track of blood sugar levels, as elevated levels over long periods in a diabetic patient can cause significant nerve damage, resulting in the onset of diabetic neuropathy.

Prevention is always better than treatment when it comes to diabetics. At-risk diabetic patients should see a medical professional every 3 to 6 months to ensure that there are no issues with their feet. Low-risk diabetic patients should be seen yearly if there are no major concerns with the integrity of their feet and lower limbs.

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