Diabetic Peripheral Neuropathy
By Esther Hansen, D.P.M.
Many people have heard the term’ Diabetic Neuropathy’, but most are unaware as the serious nature of this condition. The word neuropathy means damage to the nerves. Peripheral neuropathy refers to damage to the nerves of the peripheral nervous system which includes the hands and feet. Nerve damage that occurs from peripheral neuropathy may range from sensory loss (decreased ability to feel), motor weakness (decreased function of the muscles in the hands and/or feet) and pain.
Diabetic Peripheral Neuropathy affects millions of diabetic patients. The extent of neuropathy varies from person to person. This condition is one of the most serious risk factors for the diabetic patient. When neuropathy affects the feet, it often begins in the toes and then works its way up the extremity. One of the complications of neuropathy is the development of foot problems. Diabetics who develop peripheral neuropathy often experience tingling, pain and/ or numbness in their feet. Due to insensitivity caused by neuropathy, blisters, pressure ulcers or sores may develop. Diabetics with neuropathy are prone to developing foot deformities such as bunions, hammer toes, and Charcot foot. Charcot foot is a progressive weakening of the bones in the foot. This weakening leads to fractures and dislocations. As a diabetic patient continues to walk on the affected foot, the foot begins to change shape. The change in the shape of the foot leads to instability and severe deformity. The deformity associated with Charcot foot may lead to ulcerations, which may lead to infections and amputations. The diabetic foot is one of the leading causes of non-traumatic amputations in the United States.
Prevention is crucial in breaking the cycle of diabetic foot complications associated with neuropathy. Preventative measures include evaluation and treatment by a trained professional, diabetic shoe wear, ankle- foot orthoses, orthotic devices and other modalities.