When it comes to managing your blood glucose, keep in mind the whole-body effects of high blood glucose levels. For individuals with diabetes, continued exposure to high blood glucose can result in serious complications, including foot problems. When the body is exposed to these high levels, over time the nerves in the body can become damaged.

When the nerves in the body become damaged, this can result in neuropathy or specifically diabetic peripheral neuropathy. In fact, about 60% to 70% of all people with diabetes have some form of neuropathy, but today we're going to focus on diabetic neuropathy because it is the most common type and it impacts your feet.

What is diabetic peripheral neuropathy?

Diabetic peripheral neuropathy is a type of nerve disorder that impacts a person's legs, feet, toes, hands, and arms. Over time, a variety of factors can cause nerve damage in the body, resulting in sensations of numbness and pain in parts of the body. You may experience pain, tingling, or total loss of feeling in your extremities.

What parts of the body does peripheral neuropathy affect?

Peripheral neuropathy impacts a person's toes, feet, legs, hands, and arms. Diabetic neuropathy affects the longest nerves first, that's why the extremities of the body are affected, usually starting with the toes and feet. Keep in mind, this is a person-specific condition, and everyone will experience symptoms differently.

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What are the long term complications of diabetic peripheral neuropathy?

Like all things pertaining to health, nerve damage has different symptoms and complications for different people.  However, when you have diabetic peripheral neuropathy, you have an increased risk of foot ulcers and amputation. This typically happens, because when you lose sensation in your feet or toes it's more difficult to know if you damage your feet. Often people living with diabetes also have PAD, or decreased circulation, making it harder for them to heal from injuries. If you cannot feel, then you cannot heal. So, the key is to catch injuries and/or ulcers as soon as possible.  Each day an injury and/or ulcer is caught early = decreased cost and increased the quality of life.

For example, you could get a blister or a cut and you wouldn't know it because you don't feel pain. If you then have an injury and don't feel pain, then it can quickly turn into something worse.

Foot ulcers can respond to treatment well if you catch them early, but more serious complications can develop without proper care.

Did you know that approximately 15% of people with diabetes will get a foot ulcer, and of those with a foot ulcer up to 24% will require an amputation? Research has shown, however, that with proper attention and care this is preventable.

Preventing the Complications of Diabetic Peripheral Neuropathy

When it comes to preventing complications, the most important things to consider are proper foot care and diabetes management. First, work with your doctor and/or CDE to manage and control your blood glucose levels. By effectively maintaining your levels, you can prevent further nerve damage. However, elevated blood glucose is only one of the many causes of peripheral neuropathy so it's important to discuss your other risk factors with your doctor.

Second, take proper care of your feet. We recommend examining your feet and legs daily, along with temperature monitoring, and wearing proper footwear to prevent foot ulcers and amputations.

Additional Resources on Sugar Levels and Foot Problems for People with Diabetes

While we don't entirely know or understand all of the mechanisms that result in neuropathy, we do know that high blood sugar levels are one factor for individuals with diabetics having neuropathy. It's important to talk to your doctor and CDE about managing your blood sugar, conducting visual foot checks, and better understanding how to care for your feet. For more information on diabetic peripheral neuropathy and proper foot care check out these resources below:

• 7 Symptoms of Diabetic Peripheral Neuropathy
• Diabetic Neuropathy - Mayo Clinic
• Peripheral Neuropathy and Diabetes - WebMD
• Diabetes, Foot Care, and Foot Ulcers

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