A complication that all people with diabetes need to be aware of and on the lookout for is diabetic neuropathy. This is a disorder of the peripheral nerves, which are the nerves in the outermost portions of the body (feet, hands, etc.). Recognizing the symptoms of diabetic neuropathy are of major importance because to miss them can have life altering or even threatening affects.



Diabetic neuropathy is caused by the walls of the blood vessels that supply the nerves becoming thicker. The end result of this is less nutrients are unable to get to the nerves as well as a demyelinization (destruction of the myelin sheath that protects nerves) of the Schwann cells that surround and insulate the nerves. This slows the ability of the nerves to conduct impulses back to the brain. Sorbitol also forms and accumulates in the Schwann cells causing further nerve conduction impairment.

There are two forms of neuropathies that can form with diabetes; polynueropathies and mononeuropathies. Polynueropathies are the most common in those with diabetes and is a bilateral sensory disorder. The symptoms for this form of diabetic neuropathy are most common in the toes and feet and normally appear there first. The finger and hands can also be affected but this usually occurs during the later stages of the disease. Where the symptoms appear will depend on what nerves fibers are affected.

The symptoms can differ among individuals and is dependent on the amount of damage done to the nerves. It is a disorder that will get progressively worse if the diabetes is not properly managed. The first signs will normally be a subjective change in sensation in the extremities that can include numbness and tingling.

Other symptoms can include an aching pain, a burning or shooting sensation, or feeling like you have cold feet. As the neuropathy progresses the symptoms can include impaired sensations of pain, touch, temperature, vibration, and two-point discrimination. The only way to treat polyneuropathy is through management of the diabetes itself.

Mononeuropathies are isolated events that affect single nerves. The symptoms of this form of neuropathy are entirely dependent on which nerve is affected. They can affect the oculomotor nerve which can lead to headache, eye pains and an inability to move the eye in any direction.

Another symptom of mononeuropathies is Radiculopathy which is characterized by pain that seems to radiate from the spine to extend outward to cause symptoms away from the source of the spinal nerve root irritation. It is thought to be caused by an inadequate blood supply to the spinal nerve roots.

All diabetics, whether type 1 or type 2, need to be aware of the symptoms of diabetic neuropathy. The sooner it is brought to the attention of the diabetics health care providers the sooner it can be managed through proper lifestyle choices that are centered on diet, exercise, and proper medical management.