Tingling in the Feet: Diagnosis and Treatment of Diabetic Neuropathy

For a diabetic, tingling, pain, or numbness in the extremities may indicate a type of nerve damage associated with high blood sugar. Many patients with diabetes develop diabetic neuropathy. In fact, according to the American Diabetes Association, as many as half of all diabetics are affected by diabetic neuropathy. While a serious condition, diabetic neuropathy is preventable and does respond well to treatment designed to slow the neuropathy’s progression.

What is Diabetic Neuropathy?

Neuropathy refers to any condition that affects the body’s nerves outside of the brain or spinal cord. Diabetic Neuropathy is a dysfunction of the nerves, which is a result of a chemical process induced by diabetes. Those with high blood sugar are susceptible to nerve injury throughout the body, but it most often affects the legs and feet.

What are the Symptoms of Diabetic Neuropathy?

Diabetic neuropathy manifests in multiple ways, often depending on the classification of neuropathy. The National Institute of Health classifies diabetic neuropathy into four categories:

Peripheral Neuropathy

This is the most common form of diabetic neuropathy, and it affects the extremities, including the legs, feet, arms, and hands. Common symptoms include numbness, tingling or burning, sharp pains or cramps, weakness of the muscles, diminished awareness of temperature changes or pain, increased sensitivity to touch, and foot issues (infection, ulcers, etc.).

Autonomic Neuropathy

This type of diabetic neuropathy mostly affects the body’s internal organs. Your autonomic system is responsible for controlling your heart rate, sweating, eyes, bladder, sex organs, blood pressure, and other internal functions. When diabetes begins to affect the nerves in these areas, you may experience a range of symptoms including bladder or bowel problems, rising blood pressure, nausea and vomiting (due to gastroparesis—slow stomach emptying), difficulty swallowing, unusual sweating, sexual dysfunction, and more.

Focal Neuropathy (Mononeuropathy)

This type of neuropathy affects a single, specific nerve in the face, arm, leg, or chest. It can cause numbness or tingling, pain in the shin or foot, thigh pain, paralysis of part of the face, double vision, and weakness in the hand.

Proximal Neuropathy

This type of neuropathy is far less common than other classifications. It affects areas closer to your core, including the hip and upper leg. Those with proximal neuropathy might have pain in the buttock, hip, or thigh, weak muscles near your core, difficulty sitting up or standing, and chest pain.

When Should I See Someone for My Diabetic Neuropathy Symptoms?

“You should seek medical attention if you notice changes in your bodily functions, blood pressure, or if you have discomfort from or notice progression of sensory neuropathy,” said Foot and Ankle Specialist, Zachary Rasor, DPM, FACFAS of TPMG Foot and Ankle in Virginia Beach.

Diabetic neuropathy is a very serious complication associated with diabetes, particularly if left unaddressed. For the feet alone, failure to seek medical attention after symptoms and neglecting diabetic foot exams can lead to severe complications such as wounds, infections, and even amputations. A reduction in sensory feedback to any part of the body could have detrimental results. Our nerves act as transmitters for the body, allowing all parts of the body to communicate with each other. When nerves are damaged, that deficit can affect communication, leading to mechanical deformities, such as contractures or flat feet.

Once identified and properly treated, those with diabetic neuropathy can be spared infection, amputation, and even hospitalization.

What are Some Common Risk Factors for Diabetic Neuropathy?

Uncontrolled blood glucose levels and a sedentary lifestyle are two of the main risk factors associated with peripheral diabetic neuropathy. Some research also suggests that high-risk behaviors such as drinking in excess and smoking may also contribute to nerve damage.

How Can I Prevent Diabetic Neuropathy?

Although it is not possible to prevent all cases of diabetic neuropathy, there are a number of ways to reduce your risk. The most effective approach to prevent diabetic neuropathy is to pay close attention to your blood sugar levels and engage in routine exercise. Some medications may also reduce your risk of diabetic neuropathy; however, those who are interested in medication should consult an endocrinologist or family doctor to discuss whether a regimen would be beneficial for you. While it may not be completely preventable, adopting a healthy lifestyle can significantly reduce the likelihood of developing diabetic neuropathy.

What Diabetic Neuropathy Treatment is Available?

Individuals who experience problems with their feet because of peripheral diabetic neuropathy can take several measures to prevent further complications. The initial steps in treatment start with choosing appropriate footwear and completing daily foot exams. In certain instances, medication may be prescribed to alleviate utilized pain caused by neuropathy.

While there are some interventions, the fundamental principle for treating all forms of diabetic neuropathy is actively maintaining one’s own health. After being diagnosed with diabetic neuropathy, your healthcare provider will likely prioritize assessing your diabetes management. Consultation with a family medicine physician or endocrinologist is beneficial for determining where you might require lifestyle adjustment.

“While a diagnosis of diabetes or neuropathy is serious and can be troubling, it is a great opportunity to change your lifestyle,” said Dr. Rasor. Many of the interventions for those with diabetes or neuropathy will also benefit your heart, bone, and immune health. Incorporating a nutritional diet and exercise into your routine is something our bodies were designed to handle.

zachary rasor

About Zachary Rasor, DPM, FACFAS

Zachary Rasor, DPM, FACFAS is a board certified Foot and Ankle surgeon with TPMG Foot and Ankle in Virginia Beach. Through creativity and attention to detail, Dr. Rasor enjoys treating a variety of pathologies found in the foot and ankle. Through his treatment, he can improve mobility and reduce pain, thus restoring a patient’s quality of life. As a foot and ankle specialist in Virginia Beach, Dr. Rasor treats a variety of lower extremity conditions including severe fractures, chronic deformities, including Charcot, arthritis and tendonitis, ulcers, and ingrown nails.

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