Neuropathy

In chapter 2 we discussed how nerve damage (diabetic neuropathy) occurs in various organs. People with diabetes can have problems with the nervous system, such as decreased or a tingling sensation in the extremities, especially the feet. Decreased sensation in the feet can lead to further complications that include a loss of one or both feet. The common problem for diabetics with peripheral neuropathy is the development of skin ulcers, which commonly occur on the feet. You should check your feet regularly for any skin breakdown. If you have decreased sensation in your feet, it will be difficult for you to sense when a shoe is too tight or whether you have an object such as a small pebble in your shoe. If you were to walk around with this irritation on your skin, you would not have the normal response of either adjusting or removing your shoe or removing the small pebble. The continued irritation can lead to skin breakdown, which can lead to skin ulcers. Furthermore, ulcers can become infected; this often occurs in diabetics who do not have good glucose control. Inspecting your feet frequently can minimize and prevent foot ulcers. (See chapter 2, Caring for Your Feet.)

The best way to avoid diabetic neuropathy is to establish good control of your glucose. Many studies have shown that those who keep their glucose at or near normal levels have decreased risks for developing a neuropathy.