In 2002, according to the National Institute of Diabetes and Digestive and Kidney Disease, approximately 65% of those living with Diabetes also had some degree of correlated neuropathy. In many cases it is the symptoms of neuropathy that lead to the diagnosis of diabetes, because these symptoms indicate to the patient that there may be a larger disease process occurring.
Neuropathy by definition is disease or dysfunction of one or more peripheral nerves that typically causes numbness, weakness, or both. It is thought that a combination of factors adds to the incidence of neuropathy in diabetic patients, but it is directly related to poor sugar control. Nerves are very sensitive to change and when blood sugars are high, the sugar molecules tend to glycosylate both the small blood vessels and the small nerves. This glycosylation compresses the nerve to some degree and results in the symptomatic representation of neuropathy.
Several categories of neuropathy affect the diabetic population, but the most common type is Peripheral Neuropathy. Peripheral Neuropathy is also known as distal symmetric neuropathy, meaning symptoms present first in the toes and fingers on both the right and left sides of the body. As the neuropathy progresses it continues along the foot and hand towards the arms and legs. The sensory changes are minimal and at first may go unnoticed, but as the neuropathy progresses symptoms become more discernable. The best was to prevent and control the progression of diabetic neuropathy is to keep your blood glucose levels within normal range, thus protecting your nerves from glycosylating.
Comprehensive foot examinations by your Podiatrist can help diagnose peripheral neuropathies in the early stages and it is important to remember that if you are experiencing any changes in sensation to your toes or feet, you see your doctor immediately. Your Podiatrist will look for changes in light and sharp touch, vibration, reflexes and your ulceration risk. All of these components can hold clues to an early diagnosis of peripheral neuropathy.
If you have already been diagnosed with neuropathy it is still very important to follow-up with your Podiatrist for routine care, but more importantly to be doing your part at home. You must check your feet on a daily basis for any open areas, especially between the toes and for any color changes that may indicate problems. The largest complication associated with having diabetic neuropathy is the patients inability to feel, thus injuries that would be painful in a non-diabetic go unnoticed in a diabetic and can lead to ulceration, infection, and loss of digits. If you notice something unusual or different from the previous day, contact your Podiatrist for an appointment.
