Peripheral neuropathy is a condition that develops as a result of damage to the nerves in the feet, hands, legs and arms. Diabetes is a common cause of peripheral neuropathy. Approximately 60 to 70 percent of people with diabetes develop some form of peripheral neuropathy.
The symptoms of diabetic peripheral neuropathy can vary depending on the specific nerves that become diseased. Sensory nerve disease can cause numbness, tingling, burning, shooting or stabbing pains in the hands and feet. Motor nerve damage can lead to muscle weakness, muscle twitching, cramping, decreased reflexes and muscle atrophy (decreased muscle size). Autonomic nerve damage may cause an inability to sweat which may lead to intolerance to heat, loss of bladder control, loss of balance and loss of blood pressure regulation.
The nerve damage caused by diabetic peripheral neuropathy is more common in patients with poorly controlled blood glucose (sugar). However, even diabetic patients who have excellent blood glucose control can develop diabetic peripheral neuropathy. Other factors that increase the risk of peripheral neuropathy include long duration of diabetes, damage to blood vessels that carry oxygen and nutrients to nerves, autoimmune disorders which damage nerves, inherited traits that increase the susceptibility to nerve disease, and lifestyle factors such as smoking or alcohol use.
Podiatrists diagnose diabetic peripheral neuropathy based on the patient's history of symptoms and physical examination. Patient evaluation may include sensory testing, reflexes, vibratory sensation, etc. In some instances, additional neurologic testing such as epidermal nerve fiber density biopsy, EMG and nerve conduction studies may be necessary.
The most important step in treating diabetic peripheral neuropathy is for patients to improve blood glucose management. A multitude of medications are available to help treat and manage neuropathic pain. Vitamin supplements may also decrease the symptoms of tingling, burning and shooting pains. Physical therapy may be helpful with instances of balance problems and muscle weakness.