Foot Diabetic Neuropathy

Neuropathy in feet – also called peripheral neuropathy – is a condition that may affect people with diabetes. Patients experience numbness, weakness and sometimes even pain not only in the feet, but also in the legs, the arms, and the hands. Diabetic neuropathy pain is often not very severe, but in some cases, patients lose reflexes. The foot sometimes becomes shorter and wider. Some patients develop foot ulcers. Since the foot loses sensation, and wounds may go overlooked until they are infected. In worst cases, the infected feet may require amputation.

Diabetic neuropathy in the form of autonomic neuropathy may likewise affect the digestive system, the heart, and the reproductive organs. Proximal neuropathy affects the hips, thighs, and or buttocks area.

 

What are the symptoms of diabetic neuropathy?

Some patients suffering from neuropathy in feet exhibit no symptoms at all. Most patients, however, initially experience tingling, total numbing, or pain in the feet. The sensations may be mild at the outset, but they progress over time (usually in a matter of years) as the nerve damage worsens. Depending in the type and severity of the neuropathy, other symptoms may manifest, including nausea, indigestion, vomiting, constipation and diarrhea, pain during urination, sexual problems such as impotence or vaginal dryness.

 

Causes and risk factors

Several factors contribute to the development of neuropathy. The causes are often different for different neuropathy types. Metabolic factors such as low insulin levels, high glucose, and atypical blood fat are among the most common causes, followed by neurovascular factors that damage blood vessels. Some autoimmune factors also cause nerve inflammation, and so do inherited traits that may intensify a patient’s predisposition to neuropathy. Researches also point to smoking and alcohol and possible causes.

Studies show that half of the diabetic population has neuropathy (in different forms). The condition is most common to people who have had diabetes for no less than 25 years, people who have trouble managing their blood glucose, people with high blood fat and blood pressure, people who are overweight people, and people past their 40’s.

 

How to diagnose diabetic foot neuropathy?

If a doctor suspects that you have neuropathy, your heart rate and blood pressure may be checked. The doctor may also administer tests to check reflexes, strength of muscles, and sensitivity to vibration, position, and temperature.

Patients who are suspected to have neuropathy in feet may be asked to undergo a comprehensive foot exam. During the exam, the skin of the feet is carefully examined. The doctor also checks blood circulation in the area, and tests for sensation.
In some cases, the doctor may require the patient to undergo nerve condition studies such as electromyography and quantitative sensory testing. Ultrasound and biopsies of the skin or nerve may also be required in some cases.

 

Diabetic Neuropathy Treatment Options

Blood glucose control is the most effective (and simplest) treatment for neuropathy. A patient’s blood glucose level has to be maintained within the standard range in order to put off additional nerve damage. The doctor may design a program that helps the patient monitor his or her blood glucose, plan meals around the goal, and exercise specifically for the condition.

Some patients are advised to take either insulin injections or oral drugs that help manage blood glucose levels. Aspirins and non-steroidal anti-inflammatory drugs may also be prescribed to lessen pain. Some doctors also administer electronic nerve stimulation to impede pain. Combinations of relaxation training, hypnosis, acupuncture, and biofeedback are also sometimes used.

Patients afflicted with neuropathy in feet have to take care of their feet in order to prevent amputation (which is far too common at about 86,000 per year). Studies show that proper foot care could have prevented almost half of the neuropathy-induced amputation cases.