What is Diabetic Peripheral Neuropathy?

Diabetic peripheral neuropathy (DPN) is a type of nerve damage that affects people living with diabetes. High blood sugar levels in diabetes can injure nerves, especially in the legs and feet, over many years. This nerve damage is known as diabetic neuropathy. DPN usually affects the legs and feet but may eventually involve the hands, arms and other areas. Many people notice numbness, pain or weakness in the legs and feet as early signs of DPN.

Symptoms

The major symptoms of DPN include numbness, tingling sensation or pain in the feet and hands, which can progress from a mild irritation to an intense burning sensation. Some may also experience muscle weakness in the lower legs and feet. The symptoms typically begin in toes or feet and slowly spread upwards. In severe cases, it can lead to foot ulcers or infections which may require amputation if left untreated. Other symptoms include difficulty feeling the shape of objects held in hands, problems with balance and coordination and increased sensitivity to touch.

Causes and Risk Factors

Having high blood sugar levels over many years is the main cause of nerve damage in diabetic neuropathy. Poorly controlled diabetes increases the risk of developing DPN. Other risk factors for DPN include duration of diabetes, family history of diabetes complications, smoking, high blood pressure and high cholesterol levels. The risk is also higher in those who are overweight. DPN commonly progresses slowly over many years and is generally non-reversible. However, maintaining optimal blood sugar levels can help slow the progression of nerve damage.

Diagnosis of Diabetic Neuropathy

There is no single test to diagnose diabetic peripheral neuropathy. Doctors examine medical history and perform physical exams to check reflexes, sense of touch and vibration sensation in feet and hands using tuning fork. In advanced cases, appearance of feet may show changes like dry, flaky skin or deformed toenails. Neuropathy questionnaires can help identify symptoms. Nerve conduction studies evaluate speed of nerve impulses and electromyography assess muscle and nerve communication. Sometimes skin or nerve biopsies may be performed. DPN is diagnosed after ruling out other possible causes of neuropathy.

Managing Diabetic Neuropathy

Good blood glucose control is the mainstay treatment for DPN prevention and slowing progression. Regular self-monitoring of blood sugar and medication adherence is important. Managing other risk factors like high blood pressure and cholesterol also helps. Doctors may prescribe medications for DPN pain relief like pregabalin, duloxetine or gabapentin. Over-the-counter pain relievers and topical creams with lidocaine may help minor symptoms. Physical or occupational therapy can aid fatigue management. Properly fitted shoes and regular foot checks are necessary to prevent infections. In severe cases, TCAs (tricyclic antidepressants) or injections with local anesthetics near affected nerves may relieve symptoms. Lifestyle changes like maintaining healthy weight and quitting smoking also support better nerve health.

Diabetic Peripheral Neuropathy Complications and Prevention

Some complications result from numbness in DPN like foot injuries from walking barefoot or wearing improper footwear. Fungal infections between toes often go unnoticed due to numbness. This can lead to foot ulcers which may further progress to limb amputation in severe cases. Another potential complication is orthostatic hypotension - a sudden drop in blood pressure when standing up, which can cause dizziness and falls. Early detection and appropriate treatment can help manage DPN. Monitoring blood sugar, screening feet regularly, wearing proper shoes, quitting smoking and following doctors' advice prevents further progression and reduces risk of complications. With adequate care and diabetes control, many people with mild DPN avoid severe symptoms and prevent long-term complications.

Screening and Follow Up

People with diabetes should get screened for DPN annually or whenever they have symptoms. Doctors assess reflexes, touch and vibration sensation using simple tests. Those at high risk or with confirmed neuropathy need follow up checks every 6-12 months depending on severity. Follow up helps monitor progression, address new symptoms and adjust treatment plans. Maintaining optimal glucose control through lifestyle and medication provides ongoing benefit. People should report any changes in symptoms, new pain areas, appearance of foot ulcers or wounds to the healthcare provider promptly for timely treatment. With self-care practices and doctor visits as scheduled, DPN is mostly manageable even in advanced stages.

Conclusion

In summary, diabetic peripheral neuropathy results from long-standing high blood sugar damaging nerves over many years. It commonly affects legs and feet but may gradually involve other body areas too. Early symptoms include tingling, numbness and pain in extremities. While DPN itself is not reversible, managing blood glucose levels, risk factors and treating symptoms effectively prevents complications like foot ulcers and amputation. Maintaining optimum diabetes control and self-care helps live well with DPN.

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Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)

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1. Source: Coherent Market Insights, Public sources, Desk research
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