diabetic neuropathy

Nerves are the body's wiring, carrying sensation and signals along thin insulated cables. Years of high blood sugar fray that wiring — first in the longest cables, those reaching the feet — so messages arrive garbled or not at all. The result is numbness where there should be feeling, and sometimes burning pain where there should be calm.

Diabetic neuropathy is nerve damage caused by chronic hyperglycemia, the most common chronic complication of diabetes. Its usual form is a distal symmetric polyneuropathy that begins in the toes and feet and slowly advances upward in a ‘stocking-and-glove’ pattern, producing numbness, tingling, and neuropathic pain. Diabetes also damages the autonomic nerves controlling internal organs, causing problems such as digestive sluggishness, dizziness on standing, bladder dysfunction, and erectile dysfunction.

The loss of protective sensation in the feet is especially dangerous: an unnoticed cut or blister can ulcerate, become infected, and lead to amputation, making foot care and regular exams essential. The bedrock of prevention is good long-term glucose control, since established nerve damage is largely irreversible; treatment otherwise centers on relieving pain with specific medications and protecting the feet. Diabetes is, in fact, the leading cause of non-traumatic lower-limb amputation.