Definition

A common complication of diabetes mellitus in which nervesare damaged as a result of hyperglycemia (high blood sugar levels).

Causes

Medical research has not pinpointed the exact mechanism bywhich nerve damage occurs when there are prolonged high blood sugar levels. Itis thought that the excess sugar traveling through the bloodstream interfereswith the normal transmission of nerve impulses.

This same excess sugar in the bloodstream can weaken thewalls of the blood vessels, particularly the smaller capillaries which carrynecessary nutrients and oxygen to the nerve cells. Symptoms include diabeticperipheral neuropathy:

• Tingling
• Numbness (severe or long-term numbness can become permanent)
• Burning (especially at night)
• Pain

Treatment

The goals of treating diabetic neuropathy are to preventprogression and reduce the symptoms of the disease. Tight control of glucose isimportant to prevent progression. To reduce the symptoms, topical treatmentwith Capsaicin or oral medication like amitriptyline, gabapentin, and carbamazepinehave been used successfully. Analgesics are rarely of much benefit in thetreatment of painful neuropathy. Regular foot exams are important to identifysmall infections and prevent progression. If foot injuries go unnoticed for toolong, amputation may be required.

Prevention

It is clear that tight control of blood sugar level prevents the development of neuropathy in 60% of type 1 diabetics and decreases the severity of symptoms. In addition, regular foot care can prevent a small infection from progressing.

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