Diabetic Peripheral Neuropathy

Many of us have watched the 1999 James Bond film “The World Is Not Enough” starring the memorable villain Victor Zokas also known as Renard.  In the movie, Renard was unable to feel any sensations including pain, giving him almost superhuman abilities to endure more than what was thought physically possible.  After watching we have often reasoned, “If only I was like Renard then I wouldn’t have to feel pain!”  On the surface this is a tantalizing thought, but upon further contemplation it’s not all that it’s cracked up to be!

In fact, it is the sensation of pain that provides us with one of our greatest defenses.  The loss of this sensation, among other symptoms, is termed neuropathy, and is the result of damaged nerves. Most notably, neuropathy has been associated with diabetes and is the underlying source of many of the complications seen in diabetic patients.  According to the American Diabetes Association, nearly half of all diabetics have a form neuropathy.  This diabetic neuropathy is often characterized by symptoms of burning, aching, tingling, or numbness.  Often nerve damage progresses in severity, leading to loss of sensation to the feet and ankles.

Losing this protective sensation causes many diabetic patients to develop chronic wounds or ulcers.  In many cases, these ulcers arise from unknown trauma or a foreign object in the shoe.  Because of the lack of sensation, the patient cannot feel the object, and therefore fails to remove it; thus leading to an erosive ulcer.  If this continues, the ulcer can become infected and if the infection reaches bone, can possibly warrant an amputation.  The question then becomes how can diabetic patients prevent or stop the progression of diabetic neuropathy?

The management of diabetic neuropathy can be accomplished in the following ways:

  • Optimal Blood Glucose control is the primary approach

  • Lifestyle Modifications (diet, exercise)

  • Management of cardiovascular risk factors

  • Medications

If you currently suffer from diabetic neuropathy, in addition to the list above, it is important that you regularly examine your feet for any wounds, and that you consistently check your shoes for any foreign objects.  If you have an ulcer or suffer from nerve damage, please consider making an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona. 

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