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Why You Really Hurt
It All Starts in the foot
by Dr. Burton S. Shuler
 What does a paper clip,
a safety pin, a Lego
block, a key, a hair pin,
a rock, and a dime all
have in common? They
were all undetected foreign objects
found in the
shoes of people with
diabetic neuropathy.
What Is Diabetic Neuropathy?Diabetic neuropathy is a
nerve disorder most commonly
caused by the high
levels of sugar in
the blood. It represents
the most common complication
of diabetes. It is also the
major contributor of the
triad of diabetic neuropathy,
Peripheral Vascular Disease
and infection, which are
the primary causes of all
chronic foot diabetic
ulceration that can lead to
amputation. In fact in over
20 years in private practice
I can not ever recall
seeing a severe diabetic
foot ulcer without diabetic
neuropathy being present.
As such they represent an
ongoing health problem
to the public of major
importance. The most common
form of diabetic
neuropathy seen is
known as "distal
symmetrical
polyneuropathy." In
layman's terms this
means the nerves affected are
the far reaching
nerves seen in the hands
and feet, normally on both
right and left sides,
involving more than one
nerve. People with diabetes
can develop nerve problems
at any time. Significant
clinical neuropathy can
develop within the first 10
years after diagnosis of
diabetes and the risk of
nerve damage increases the
longer the patient is a
diabetic. It has been
published that as high
of 60% of diabetics have
nerve damage. Diabetic
neuropathy emerges more
commonly in patients over
40 who are smokers and 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 glucose,
a condition that causes
chemical changes in
nerves. Again, we don't
know why high glucose
affects the nerves, but we
do know that it does.
Studies have shown that
high glucose levels
affect many chemical pathways
to the nerves, causing a
build up in the nerve of a
chemical known as
sorbitol while decreasing
the chemical called
myoinositol. Several
scientists feel this may be
the "missing link" in the
ultimate treatment of
diabetic neuropathies,
but as of now no one
is sure.High blood glucose also
damages 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 nerves ability to
work will be effected.
That is why it is so
important that the blood
supply to the feet and
legs in a diabetic not be
hampered. Inherited factors also
come in to play, but at the
present time no one knows
exactly why.  Back |
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