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What Is Diabetic Peripheral Neuropathy?

muscle weakness

Story at-a-glance -

  • Diabetic peripheral neuropathy occurs when a patient's feet and legs are affected by nerve damage, followed by the hands and arms
  • While the cause of the disease is unclear, a combination of factors likely play a role in the development of diabetic neuropathy, such as the complex interaction between nerves and blood vessels

Diabetic neuropathies are a family of nerve disorders triggered by diabetes. There are four forms of this disease, with diabetic peripheral neuropathy being the most common. Diabetic peripheral neuropathy occurs when a patient's feet and legs are affected by nerve damage, followed by the hands and arms.

Diabetic neuropathy disorders in general are mainly triggered by prolonged exposure to high blood sugar levels, which can damage delicate nerve fibers.1,2,3

The Mayo Clinic points out that while the cause of the disease is unclear, a combination of factors likely play a role in the development of diabetic neuropathy, such as the complex interaction between nerves and blood vessels.

High blood sugar levels are known to interfere with the nerves’ ability to transmit signals and weaken the capillaries or walls of the small blood vessels that provide oxygen and nutrients to the nerves.

Symptoms and Complications of Diabetic Peripheral Neuropathy

Some of the initial symptoms of diabetic peripheral neuropathy include:4,5

  • Numbness or insensitivity to pain or temperature
  • A tingling, burning or prickling sensation
  • Sharp pains or cramps
  • Extreme sensitivity to touch, even light touch
  • Muscle weakness
  • Loss of reflexes, especially in the ankle
  • Loss of balance and coordination
  • Serious foot problems such as ulcers, infections, deformities and bone and joint pain

These symptoms are known to worsen at night. Many diabetics already show signs of neuropathy that a doctor can take note of, but patients themselves don’t feel them.

If left untreated, diabetic peripheral neuropathy can lead to muscle weakness and loss of reflexes, especially at the ankle, eventually causing changes in the way a person walks. Foot deformities, such as hammertoes (a deformity that causes the toe to bend or curl downward instead of pointing forward6) and the collapse of the midfoot, may occur too.

Should pressure or an injury remain unnoticed, this can prompt blisters and sores to appear on numb areas of the foot. If there is an infection that’s not treated immediately, it can spread to the bone and may require the foot to be amputated. Fortunately, many amputations are preventable if minor problems are examined and treated immediately. 

Other Risk Factors of Diabetic Peripheral Neuropathy

Peripheral neuropathy can also be triggered by factors apart from diabetes, namely: 7

  • Shingles (post herpetic neuralgia)
  • Vitamin deficiency, particularly of vitamin B9 (folate) and B12
  • Alcohol intake
  • Autoimmune diseases such as lupus, rheumatoid arthritis or Guillain-Barre syndrome
  • AIDS, whether from the disease or its treatment, or from syphilis or kidney failure
  • Inherited diseases such as amyloid polyneuropathy or Charcot-Marie-Tooth disease
  • Exposure to toxins, such as heavy metals, gold compounds, lead, arsenic, mercury and organophosphate pesticides
  • Cancer therapy drugs like vincristine (Oncovin and Vincasar) and antibiotics including metronidazole (Flagyl) and isoniazid
  • Diseases such as neurofibromatosis, Fabry disease, Tangier diseases, hereditary sensory autonomic neuropathy and hereditary amyloidosis (albeit rare)
  • Statins — however, neuropathy caused by these medications rarely causes symptoms

Diabetic peripheral neuropathy is a major health concern. If you experience any of the symptoms mentioned here, consult a doctor immediately. If someone you know exhibits these signs, but is unaware that they are symptoms of diabetic peripheral neuropathy, talk to them about having their condition checked.

You can make a big impact in improving their health and may even help save their lives by being aware of this disorder.

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