Diabetic neuropathy is a group of nerve disorders caused by diabetes. People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater the risk of diabetic neuropathy. Diabetic neuropathy leads to numbness, pain, and weakness in the hands, arms, feet, and legs. Approximately 50 percent of those with diabetes have some form of diabetic neuropathy.

Neuropathic pain may have continuous and/or episodic (paroxysmal) components. The latter are likened to an electric shock. Common qualities of the pain include burning or coldness, "pins and needles" sensations, numbness and itching. "Ordinary" pain results from exclusive stimulation of pain fibers, while neuropathic pain often results from the firing of both pain and non-pain (touch, warm, cool) sensory nerve fibers serving the same area. The result is signals that the spinal cord and brain do not normally receive.

Nerve Damage

One problem is damage to nerves in your legs and feet. With damaged nerves in diabetic feet, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy. It can lead to a large sore or infection.

 

Poor Blood Flow

The second problem with diabetic feet happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral vascular disease. Smoking when you have diabetes makes blood flow problems much worse.

Impact on Diabetic Feet

These two causes can work together to worsen diabetic feet.

 

For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. If blood glucose is high, the extra glucose feeds the germs. Germs grow, and the infection gets worse. Poor blood flow to your legs and feet can slow down healing. Once in a while, a bad infection never heals. The infection might cause gangrene. If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

 

To keep gangrene from spreading, a doctor may have to do surgery to cut off a digit or part of the foot.


diabetes.emedtv

Written by/reviewed by: Arthur Schoenstadt, MD

Last reviewed by: Arthur Schoenstadt, MD