Diabetic neuropathy almost always starts in the feet because these are the longest nerves in the body. They are also fed by the most extended blood vessels in the body. The peripheral neuropathy that is characteristic of diabetes is found only in the presence of high blood sugar levels.
Neuropathy is the most common complication of diabetes. It appears to be caused by damage to small blood vessels. Nerves depend on multiple tiny vessels that carry nutrients and oxygen to keep each segment of these very long nerves intact. Damage to one small segment can result in loss of feeling, pain, or burning sensations that bother the feet and legs.
Preventing Neuropathy
Preventing neuropathy begins by avoiding the loss of circulation that will result in severe nerve damage. This is relatively easy today if the risks for circulatory problems are recognized early. Keeping the blood pressure below 130/80 is essential for reducing damage to blood vessel walls. Preventing plaque formation is also critical. This is done with medications that lower triglycerides and raise HDL, such as gemfibrozil and niacin, and those that lower LDL and make it lighter, such as statins.
Certain blood pressure medications called ACE inhibitors can also protect blood vessel walls. High-dose vitamin E may improve blood flow, although 1200 mg to 1500 mg a day is usually required for this effect to be seen.
Significant clinical neuropathy can develop within the first 10 years after diagnosis of diabetes, and the risk of nerve damage increases the longer one has diabetes. Some studies show that as many as 60% of those with diabetes have nerve damage. Neuropathy is more common in those over 40, smokers, and those who don’t keep their blood sugar under control.
What Causes Diabetic Neuropathy?
Medical literature has mentioned many factors as possible causes of diabetic neuropathies, but scientists do not know precisely what causes the condition. However, several factors are likely to contribute to the disorder. They are high blood sugar levels, disease of the blood vessels, high lipid levels (cholesterol and triglycerides), environment, and genetic considerations. Far and away, the common cause is high blood sugar, which causes chemical changes in nerves.
High blood sugars damage both large and small blood vessels that carry oxygen and nutrients to the nerves. If not enough blood is sent to the nerve, the nerve’s ability to work will be affected. That is why it is so essential that the blood supply to the feet and legs of a diabetic is not hampered.
More Information
- Medicine.net has good basic and treatment options
- Additional information from the Mayo Clinic
- NIDDK gives a suitable General Description of nerve damage.
- Joslin Clinic offers information, definitions, causes, and treatments
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