Due to the recent COVID-19 concern, we want to assure everyone about how we sanitize our office, we follow all universal precautions. • All rooms are wiped down fully on all surfaces between every single patient with disinfecting wipes (that kill all viruses including the Coronavirus), • All instruments are sterilized. • The entire office is cleaned daily and the waiting area is wiped down with disinfectant wipes throughout the day. • Everyone washes their hands between every single patient with antibacterial soap. You can rest assured we are following all the appropriate guidelines regarding the cleanliness and disinfection of our entire office and instruments. We do ask if you are ill to please cancel your appointment and follow your doctor's orders and please keep us updated of any diagnosis you have so we can protect our staff and other patients. If you have traveled to a location (international or local) where cases of COVID-19 have a high risk of community transmission, please call us to determine if you should keep your appointment. Thank you for understanding and we assure you we are doing everything we can to make sure our office is safe for all. We now offer telehealth services, please click on the link to request an appointment.
What is Diabetic Peripheral Neuropathy?
Diabetic neuropathy is nerve damage caused by diabetes. When it affects the arms, hands, legs and feet it is known as diabetic peripheral neuropathy. Diabetic peripheral neuropathy is different from peripheral arterial disease (poor circulation), which affects the blood vessels rather than the nerves.
Three different groups of nerves can be affected by diabetic neuropathy:
Diabetic peripheral neuropathy doesn’t emerge overnight. Instead, it usually develops slowly and worsens over time. Some patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase the likelihood of having diabetic neuropathy.
The loss of sensation and other problems associated with nerve damage make a patient prone to developing skin ulcers (open sores) that can become infected and may not heal. This serious complication of diabetes can lead to loss of a foot, a leg, or even a life.
Causes
The nerve damage that characterizes diabetic peripheral neuropathy is more common in patients with poorly managed diabetes. However, even diabetic patients who have excellent blood sugar (glucose) control can develop diabetic neuropathy. There are several theories as to why this occurs, including the possibilities that high blood glucose or constricted blood vessels produce damage to the nerves.
As diabetic peripheral neuropathy progresses, various nerves are affected. These damaged nerves can cause problems that encourage development of ulcers. For example:
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Symptoms
Depending on the type(s) of nerves involved, one or more symptoms may be present in diabetic peripheral neuropathy.
For sensory neuropathy:
For motor neuropathy:
For autonomic neuropathy:
Diagnosis
To diagnose diabetic peripheral neuropathy, the foot and ankle surgeon will obtain the patient’s history of symptoms and will perform simple in-office tests on the feet and legs. This evaluation may include assessment of the patient’s reflexes, ability to feel light touch, and ability to feel vibration. In some cases, additional neurologic tests may be ordered.
Treatment
First and foremost, treatment of diabetic peripheral neuropathy centers on control of the patient’s blood sugar level. In addition, various options are used to treat the painful symptoms.
Medications are available to help relieve specific symptoms, such as tingling or burning. Sometimes a combination of different medications is used.
In some cases, the patient may also undergo physical therapy to help reduce balance problems or other symptoms.
Prevention
The patient plays a vital role in minimizing the risk of developing diabetic peripheral neuropathy and in preventing its possible consequences. Some important preventive measures include:
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