Diabetic neuropathy almost always starts in the feet because these are the longest nerves in the body. They are also fed by the longest 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 represents the most common complication of diabetes. Neuropathy appears to be caused by damage to small blood vessels. Nerves depend on multiple tiny vessels that carry nutrients and oxygen to keep each and every 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 begins by preventing the loss of circulation that will result in serious 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 the statins.
Blood vessel walls can also be protected with certain blood pressure meds called ACE inhibitors. Blood flow may be improved with high dose vitamin E, 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?
Many factors have been mentioned in medical literature as possible causes of diabetic neuropathies, but scientists do not know exactly 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 consideration. 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 there is not enough blood being sent to the nerve, the nerve’s ability to work will be affected. That is why it is so important that the blood supply to the feet and legs in a diabetic not be hampered.
- Medicine.net has good basic and treatment options
- Additional information from the Mayo Clinic
- Visit the Neuro-Patient Resource Centre information for patients and their families.
- NIDDK gives a good General Description of nerve damage.
- Joslin Clinic offers information, definitions, causes and treatments