People who suffer from diabetes may eventually develop a form of nerve damage that is called diabetic neuropathy. This neuropathy, or damage to the nerve cells, are caused by high blood sugar that is throughout the body. The nerves that are usually most affected are the nerves in the legs and feet.
The symptoms that a person with diabetic foot problems will experience will depend upon the nerves of the feet that are affected. Although this is one of the more common side effects of diabetes it can also be prevented or slowed with tight control of blood sugar and a healthy lifestyle.
There are four different types of neuropathy. A sufferer can have one type or symptoms of several types. In some cases people will experience the symptoms of neuropathy before they even realize they have diabetes. The symptoms will often come on gradually and they may not be apparent until considerable damage to the nerve bundles have been done.
Peripheral neuropathy is the most common and the type that causes the diabetic foot problems. The other types of neuropathy affect the autonomic system (controls the heart, lungs, stomach and intestines), proximal neuropathy that is marked by severe pain in the hips and buttocks or focal neuropathy that affects one nerve and will often spontaneously resolve within weeks.
People who suffer from peripheral neuropathy will have damage to the nerves that control or provide sensation to the legs, feet, arms and hands –but the legs and feet are affected most often. The symptoms can include numbness, tingling or burning, sharp or electric shock type pain that is worse at night, loss of balance and coordination, muscle weakness, extreme sensitivity to touch or serious skin problems that include ulcers, infections, and bone and joint pain.
Those who suffer from diabetes are at a much higher risk of developing neuropathy than those in the general population. But, this can also be prevented, slowed or the risk decreased by taking several steps. By knowing what makes a person more susceptible to the nerve damage they are better able to control their risk and decrease the problems.
One risk is poor blood glucose control. In other words, when the diabetic allows their blood sugar to get out of control frequently they are at a much higher risk of developing this complication. Keeping the blood glucose (sugar) in target range using both daily measurements and A1c measurements is the best way to protect the health of the nerves and blood vessels.
Another factor, over which there is no control, is the length of time that diabetic suffers from the condition. The longer the diabetes exists in the body the more at risk the individual is. The highest rate of individuals with peripheral neuropathy are those people who have had diabetes for at least 25 years. The corresponds to another factor – age. The older the person the higher the risk. Men also have a greater risk of developing the condition than women.
Some factors that are controllable are smoking and cholesterol levels. People with a high level of LDL cholesterol have a higher risk of damage and those who smoke also will find that wounds heal more slowly and the peripheral nerve integrity is damaged.
There is no known cure for diabetic foot problems except to treat the symptoms and help the individual to slow the progress of the damage. Treatment protocols will focus on four main factors – slowing the progress, managing complications, restoring function and relieving pain.
Providing pain relief is a difficult part of the treatment protocol because nerve pain is one of the more difficult to treat. At this time there are several different types of medications that can be used but they don’t work for everyone and most have side effects that have to be weighed against the benefits of pain relief.
Physicians will help the individual through trials of these different medications to see which will work best for the individual and to help them manage the pain which will also help to restore function. These classes of medication include anti-seizure medications, anti-depressants, Lidocaine, Capasicin, or oral analgesics. In addition to medications practitioners may explore the useof transcutaneous electrical nerve stimulation (TENS), biofeedback, acupuncture and hypnosis.