DIABETIC PERIPHERAL NEUROPATHY

What is Diabetic that can become infected and may constricted blood vessels produce Peripheral Neuropathy? not heal. This serious complication of damage to the nerves. iabetic neuropathy is nerve diabetes can lead to loss of a foot, a As diabetic peripheral neuropathy D damage caused by diabetes. leg, or even a life. progresses, various nerves are The type of neuropathy occurring in affected—and these damaged nerves the arms, hands, legs and feet is Signs and Symptoms can cause problems that encourage known as diabetic peripheral Depending on the type(s) of nerves development of ulcers. For example: neuropathy. Diabetic peripheral involved, one or more signs and • Deformities (such as bunions or neuropathy is different from symptoms may be present in hammertoes) resulting from peripheral arterial disease (poor diabetic peripheral neuropathy. motor neuropathy may cause circulation), which affects the blood For sensory neuropathy: shoes to rub against toes, creating vessels rather than the nerves. • Numbness or tingling in the feet a sore. The numbness caused Three different groups of • Pain or discomfort in the feet or by sensory neuropathy can make nerves can be affected by diabetic legs—including prickly,sharp the patient unaware that this is neuropathy: pain or burning feet happening. • Sensory nerves, which enable For motor neuropathy: people to feel pain, temperature, • Muscle weakness and loss of and other sensations muscle tone in the feet and Motor Neuropathy (Deformity) • Motor nerves, which control the lower legs + muscles and give them their • Loss of balance strength and tone • Changes in foot shape that can Ill-fitting Shoes

• Autonomic nerves, which allow lead to areas of increased pressure + the body to perform certain For autonomic neuropathy: Sensory Neuropathy involuntary functions, such as • Dry feet (Numbness) sweating. • Cracked skin =

Ulcers (Sores) Diabetic peripheral neuropathy What Causes Diabetic doesn’t emerge overnight—instead, it Peripheral Neuropathy? usually develops slowly and worsens The nerve damage that characterizes over time. Some patients have this diabetic peripheral neuropathy • Because of numbness, a patient condition long before they are is more common in patients with may not realize that he or she has diagnosed with diabetes. Having poorly managed diabetes. stepped on a small object and cut diabetes for several years may However, even diabetic patients the skin. increase the likelihood of having who have excellent blood sugar • Cracked skin caused by diabetic neuropathy. (glucose) control can develop autonomic neuropathy,combined The loss of sensation and other diabetic neuropathy.There are with sensory neuropathy’s problems associated with nerve several theories as to why this numbness and problems damage make a patient prone to occurs, including the possibilities associated with motor neuropathy developing skin ulcers (open sores) that high blood glucose or can lead to developing a sore. Diagnosis Medications are available to help • Wear well-fitting shoes to avoid To diagnose diabetic peripheral relieve specific symptoms, such as getting sores. neuropathy,the foot and ankle tingling or burning. Sometimes a • Inspect your feet every day. If you surgeon will obtain the patient’s combination of different medications notice any cuts, redness, blisters, history of symptoms and will is used. or swelling, see your foot and perform simple in-office tests on the In some cases, the patient may ankle surgeon right away.This can feet and legs. This evaluation may also undergo physical therapy to prevent problems from becoming include assessment of the patient’s help reduce balance problems or worse. reflexes, ability to feel light touch, other symptoms. • Visit your foot and ankle surgeon and ability to feel vibration. In some on a regular basis for an cases, additional neurologic tests Prevention examination to help prevent the may be ordered. The patient plays a vital role in foot complications of diabetes. minimizing the risk of developing • Have periodic visits with your Treatment diabetic peripheral neuropathy and primary care physician or First and foremost, treatment of in preventing its possible endocrinologist. The foot and diabetic peripheral neuropathy centers consequences. Some important ankle surgeon works together on control of the patient’s blood sugar preventive measures include: with these and other providers to level. In addition, various options are • Keep blood sugar levels under prevent and treat complications used to treat the symptoms. control. from diabetes. L

This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle Surgeons, a professional society of 6,200 foot and ankle surgeons. Members of the College are Doctors of Podiatric Medicine who have received additional training through surgical residency programs. The mission of the College is to promote superior care of foot and ankle surgical patients through education, research and the promotion of the highest professional standards. Copyright © 2007,American College of Foot and Ankle Surgeons • www.FootPhysicians.com