DIABETIC PERIPHERAL NEUROPATHY

Neuropathies are among the most common of all the long-term complications of diabetes,
affecting up to 50% of patients.1 Peripheral neuropathy is a type of nerve damage that
typically affects the feet and legs and sometimes affects the hands and arms. This type of
neuropathy is very common. There were lacks of awareness and inappropriate management
of diabetic peripheral neuropathy (DPN), so this issue has led to much unnecessary morbidity
and become a burden at great costs.2

RISKS FACTOR CLINICAL MANIFESTATION

Over time, high blood glucose in the blood from

diabetes can damage your nerves and the small blood
vessels that nourish your nerves, leading to peripheral
neuropathy. Symptoms :
 Burning sensation
 Numbness, or tingling sensation
 Pain in
your
feet,
legs,
hands,
and
arms, even when they are touched lightly.
 Problems sensing pain or temperature in these
parts of your body.
Most of the time, you will have symptoms on both sides of your body. However, you may have
symptoms only on one side. The characteristic polyneuropathy and distal sensory peripheral
neuropathy are present in about 80% of patients. This is often described as a "stocking-glove
distribution," and it can take several years to develop. Autonomic neuropathy is also very
common in diabetes and can affect the gastrointestinal, cardiovascular, and genitourinary
organs. Typical symptoms include abdominal discomfort, dysphagia, nausea, fecal incontinence,
constipation, diarrhea, hypotension, sinus tachycardia, variable heart rate, syncope, weak
urinary stream, straining to void, incomplete emptying of bladder, heat intolerance, gustatory
sweating, & extreme diaphoresis.
 Fig 1. Stocking-glove distribution in peripheral neuropathy

PATIENT EDUCATION
The best treatment is prevention, and strategies for reducing injuries are highly effective
and well tested.
- Patients with diabetes should have a complete foot examination annually & a visual
examination of the feet at each visit ( every 3-4 months)
- Patients should be educated well on monitoring blood sugar levels and perform self—
examination of their feet every day to look for ulcers, wounds, or any broken skin.
- Patient should follow a diet plan as well as take medications on time as advised by the
doctor and too tight shoes should not be worn by the patient.

REFERENCES
1. Boulton AJM, Malik RA, Arezzo JC, Sosenko JM: Diabetic somatic neuropathies: a
technical review. Diabetes Care 27:1458-1486, 2004
2. Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic neuropathy: a position statement by
the American Diabetes Association. Diabetes Care. 2017;40(1):136–154