What is diabetic neuropathy?
Diabetic neuropathy is a long term complication of diabetes, in which we see damage to nerve tissue. Most of the times it is peripheral neuropathy, i.e peripheral nerves are mainly affected. Sometimes autonomic nerves i.e nerves supplying herat and intestine can also be affected and this problem is called as autonomic neuropathy.

How does diabetic neuropathy occur?
What is pathophysiology of diabetic neuropathy? It is not known, how diabetes damages nerves, but some studies showed that small blood vessels supplying nerves are blocked by process of atherosclerosis in diabetes thus damaging the nervous tissue as well.

Symptoms of Diabetic peripheral neuropathy:
Numbness or tingling sensation usually in the feet and legs first, then the hands
Pain in toes and feet minor to severe in intesity. Extreme sensitivity to slight touch can also be seen, allodynia.
Muscle weakness can also be seen. You may have double vision or drooping eyelids, or atrophy of the thigh muscles

Symptoms of autonomic neuropathy
Arthostatic hypotension or postural hypotension, i.e low blood pressure when rising from sitting or lying position.
Irregular heart beat
Erectile dysfunction
Nausea vomiting
Diarrhea constipation.

How to prevent diabetic nephropathy
Number one point is to control your blood glucose level at normal range with regular exercise and medicines. Maintain your normal blood pressure. Exercise will help you alot to keep your blood sugar, cholesterol and blood pressure within normal limits. If you are a chronic smoker then stop smoking. Stop taking alcohol, or atlease reduce it, as alcohol can also cause neuropathy and so worsen the problem. Always take care of your feet, inspect these for any minor injury or trauma. Follow a healthy diet plan. Keep in touch with your doctor.

Treatment of Diabetic Neuropathy:
The main goal of treatment of diabetic neuropathy is to stop progression of nerve tissue damage and relieve symptoms. Diabetic neuropathy can not be reversed as at present no such specific treatment available. Once you have diabetic neuropathy, it will persist indefinitely, however you can stop progression of neuropathy by controlling your blood glucose levels. Best treatment is to control the blood glucose level, high blood pressure and cholesterol. Mostly the treatment is symptometic. Muscle weakness can be treated with supports braces. Regular exercise and physical therapy may help maintain muscle strength. Pain may be relieved by pain killer drugs like Analgesics, some antidepressants( Antidepressants are sometimes indicated as patients may have depression due to chronic and severe pain in legs), and anticonvulsant medicines may be prescribed for relief of pain, burning, or tingling sensation. Sometimes walking regularly, warm baths, or using elastic stockings may help relieve leg pain. Medicines are also available to control nausea vomiting constipation or diarrhea. Erectile dysfunction can also be treatable with medicines or prosthetic devices. Preventing body injuries like cuts burns fracture of bones is very important as diabetic neuropathy patients have more complications from minor trauma and injuries and may have healing difficulties.

What will happen if I am having diabetic neuropathy in my foot.
When you will develop diabetic neuropathy, it will damage your nerves in legs and feet, you will feel numbness and your sensation of pain will be decreased remarkably. When you will have this stage then you will not have any feeling in your feet and you could have feet trauma without knowing it. You may feel difficulty in walking due to your leg muscles atrophy (decrease in size of muscles) and weekness. External Skin of your feet will be damaged and may develop sores and ulcers. If your cracked skin becomes infected, it is very bad condition, in some cases you will have to go for amputation(Removal) of your feet. It is very important to control diabetes as on one side due to diabetes, you will have neuropathy leading to injury of your feet and on other side diabetes causes very poor healing of injured or infected feet.

What can I do to prevent my foot problems from diabetic neuropathy
It is very important to examin and check your feet everyday, if it is difficult to examin from bottom of your feet, you may use mirror for this purpose. Always consult your doctor first, if you are diabetic and ever notice redness, swelling, infection, pain tingling or numbness of your feet or legs. If you are visiting your doctor, always show him your feet whenever you notice anything that seems not ok. Selection of your shoes is very very important. Always choose right shoes for you. Usually new shoes or the shoes that don’t fit properly are main cause of foot sores. Try to prefer those shoes that have good arch support and fit properly. Using soft leather shoes is also good. Tight shoes should be avoided. If you are going to buy a shoe for you, then try to go to market at end of day when your feet are a little swollen. If you are not satisfied with the size of your shoe, then you may go for custom molded shoes which have plenty of space for your toes. Wear your new shoes very slowly, first you wear new shoes for 1-2 hours, then take off your shoes and examin your feet for any red spots. If you notice any red spot then try to avoid those shoes until the red spots are gone. Now slowly break in those shoes by wearing them one hour longer each day every 3 days. Try to avoid dark colored socks, and always wear white or light color socks to see any spot of blood from sores.

Always keep your feet clean by washing them daily with warm water. Pay attention to areas between your toes while washing your feet. Use a very soft towel to dry up your feet after washing them with warm water. Avoid from rubbing your feet. Keep your feet skin smooth by applying any cream or lotion. Apply creams specially on your heels. If you have problem of excessive sweating in your feet, then you may use non-medicated powder before wearing your socks and shoes.

Barefoot walk is not allowed if you are a patient of diabetic neuropathy. Always avoid habits that are not good for your foot. Now come to your selection of socks, always avoid highly stretched socks, nylon socks, inside seams socks, elastic band socks. Always prefer some loose socks. Do not pour hot water on your feet. Avoid electric blanckets for your feet. You must not use heating pads to warm your feet. Also avoid rubbing alchohol or witch hazel on your feet. Keep your feet clean and healthy, rest assure you will not develop bad complications of diabetic neuropathy.