Neuropathy is nerve damage. Symptoms can be pain, tingling, or numbness, loss of feeling in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.
About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.
Nerve damage is likely due to a combination of factors such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin, neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerve, autoimmune factors that cause inflammation in nerves , mechanical injury to nerves, such as carpal tunnel syndrome ,sciatica, tarsal tunnel injury, inherited traits that increase susceptibility to nerve disease , lifestyle factors, such as smoking or alcohol use.
First symptom are often numbness, tingling, or pain in the feet. This may be more intense during the night hours and wake people from sleep. Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time. Symptoms can involve the sensory, motor, and autonomic-or involuntary-nervous systems. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe. Symptoms of nerve damage may include numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers .
People with diabetes should have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams. A comprehensive foot exam assesses the skin, muscles, bones, circulation, and sensation of the feet. Your doctor may assess protective sensation or feeling in your feet by touching your foot with a nylon monofilament-similar to a bristle on a hairbrush-attached to a wand or by pricking your foot with a pin. People who cannot sense pressure from a pinprick or monofilament have lost protective sensation and are at risk for developing foot sores that may not heal properly. The doctor may also check temperature perception or use a tuning fork, which is more sensitive than touch pressure, to assess vibration perception.
People with neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers.
More than half of all lower-limb amputations in the United States occur in people with diabetes-86,000 amputations per year. Doctors estimate that nearly half of the amputations caused by neuropathy and poor circulation could have been prevented by careful foot care.
Follow these steps to take care of your feet:
- Clean your feet daily, using warm-not hot-water and a mild soap. Avoid soaking your feet. Dry them with a soft towel and dry carefully between your toes.
- Inspect your feet and toes every day for cuts, blisters, redness, swelling, calluses, or other problems. Use a mirror-laying a mirror on the floor works well-or get help from someone else if you cannot see the bottoms of your feet. Notify your health care provider of any problems.
- Moisturize your feet with lotion, but avoid getting the lotion between your toes.
- After a bath or shower, file corns and calluses gently with a pumice stone.
- Each week or when needed, cut your toenails to the shape of your toes and file the edges with an emery board.
- Always wear shoes or slippers to protect your feet from injuries. Prevent skin irritation by wearing thick, soft, seamless socks.
- Wear shoes that fit well and allow your toes to move. Break in new shoes gradually by first wearing them for only an hour at a time.
- Before putting your shoes on, look them over carefully and feel the insides with your hand to make sure they have no tears, sharp edges, or objects in them that might injure your feet.
Millions of people are affected with diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of, or else the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.
It is very important to always wash and dry the feet thoroughly, especially in between the toes, when diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain. You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the die. Additionally, well-fitting socks are highly recommended.
A diabetic’s physician should always monitor their Hemoglobin A1C levels to test how well the blood sugars are being controlled during the past 3 months. It is very important to keep blood sugar levels at normal range, 70-110mg/dl. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with neuropathy of a diabetic patient. It is also advised to see a podiatrist if experiencing any feet conditions. Toe nails may also need to be taken care of by a podiatrist, since some patients may cut too deep around the cuticles, causing infection.
A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. When using tools to remove calluses, use caution, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to call a podiatrist.
On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound gets too bad to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can cause in diabetics that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.