Diabetic neuropathy. When your feet burn.

What is diabetic neuropathy?

Diabetic neuropathy is an impairment of the nerve terminal that is frequently seen in people with diabetes or prediabetes. Diabetes may cause several types of damage to the nervous system. The most common type of nerve injury occurs in a “stocking-glove” distribution. Here we will discuss this pattern of nerve injury, which is most commonly called diabetic neuropathy.

What are the symptoms of diabetic neuropathy?

Some of the most common symptoms of diabetic neuropathy include:

  • Pain
  • Burning sensation
  • Numbness
  • Tingling
  • Pins and Needles sensation

The symptoms are most commonly noticed in the feet but may go up the legs and hands. Some patients may develop loss of balance or muscle weakness if the neuropathy is severe or affects the motor nerve fibers.

What are the possible complications of diabetic neuropathy?

  • Skin ulcers in the feet due to diminished sensation
  • Infected skin ulcers, which may result in lower limb amputations
  • Chronic pain
  • Decreased balance leading to falls

How is diabetic neuropathy diagnosed?

A throughout medical history and physical exam is the most crucial component for the evaluation of diabetic neuropathy. Based on the initial evaluation, diagnostic tests may include:

  • Nerve conduction tests- to evaluate the function of the nerves.
  • MRI- if symptoms are considered to be related to problems of the lumbar spine.
  • Laboratory blood tests- to evaluate the glucose levels, and to look for causes of neuropathy other than diabetes.

How is diabetic neuropathy treated?

A strict control of the blood glucose levels is essential in the treatment of diabetic neuropathy. An adequate diet and regular exercise are recommended to help control the blood sugar levels. The evaluation and treatment of any other co-existing conditions (such as high cholesterol levels) is also advised. These lifestyle changes should be complemented by avoiding the use of alcohol and cigarette.

The other aspect to consider is pain control. There are different classes of medications that can be used for the management of diabetic neuropathic pain. Treatment options may include:

  • Pregabalin
  • Duloxetine
  • Gabapentin
  • Opioids such as Tapendalol (beware of addiction potential).
  • Other options such as Capsaicin cream and Lidocaine patches.

Physical measures might help with the relief of pain, such as receiving transcutaneous electrical nerve stimulation (TENS). If there are balance problems or frequent falls, physical therapy could be helpful.

It is important to inspect the skin of the feet regularly and to wear adequate shoes and socks.

Bottom Line

Diabetic neuropathy is a nerve terminal impairment that occurs in people with diabetes or prediabetes. Early detection and treatment of elevated blood glucose levels are crucial for the prevention and management of diabetic neuropathy. There are several treatment options available to address the neuropathic pain. Lifestyle changes and foot care are essential to avoid any further complications.