Dr. Gouin is trained and certified to perform surgical relief of Diabetic Neuropathy.
Dr. Lee Dellon at John Hopkins University.
(close this window to return to this page)
Click here to view Dr Lee Dellon's website regarding relief of burning and tingling of
is Diabetic Peripheral Neuropathy?
Diabetic neuropathy is nerve damage caused by diabetes. The type of neuropathy
occurring in the arms, hands, legs and feet is known as diabetic peripheral neuropathy. Diabetic peripheral neuropathy is
different from peripheral arterial disease (poor circulation), which affects the blood vessels rather than the nerves.
different groups of nerves can be affected by diabetic neuropathy:
Sensory nerves, which enable people to feel pain, temperature,
and other sensations
Motor nerves, which control
the muscles and give them their strength and tone
Autonomic nerves, which allow the body to perform certain involuntary functions, such as sweating.
peripheral neuropathy doesn’t emerge overnight—instead, it usually develops slowly and worsens over time. Some
patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase
the likelihood of having diabetic neuropathy.
The loss of sensation and other problems associated with nerve
damage make a patient prone to developing skin ulcers (open sores) that can become infected and may not heal. This serious
complication of diabetes can lead to loss of a foot, a leg, or even a life.
Signs and Symptoms
Depending on the
type(s) of nerves involved, one or more signs and symptoms may be present in diabetic peripheral neuropathy.
Numbness or tingling in the feet
Pain or discomfort in the feet or legs—including prickly, sharp pain or burning feet
For motor neuropathy:
For autonomic neuropathy:
What Causes Diabetic Peripheral Neuropathy?
nerve damage that characterizes diabetic peripheral neuropathy is more common in patients with poorly managed diabetes. However,
even diabetic patients who have excellent blood sugar (glucose) control can develop diabetic neuropathy. There are several
theories as to why this occurs, including the possibilities that high blood glucose or constricted blood vessels produce damage
to the nerves.
As diabetic peripheral
neuropathy progresses, various nerves are affected—and these damaged nerves can cause problems that encourage development
of ulcers. For example:
Deformities (such as bunions or hammertoes) resulting from motor neuropathy may cause shoes to rub against toes, creating a sore. The numbness caused by sensory neuropathy
can make the patient unaware that this is happening.
Because of numbness, a patient may not realize that he or she has stepped on
a small object and cut the skin.
skin caused by autonomic neuropathy, combined with sensory neuropathy’s numbness and problems associated with motor
neuropathy can lead to developing a sore.
To diagnose diabetic peripheral
neuropathy, the foot and ankle surgeon will obtain the patient’s history of symptoms and will perform simple in-office
tests on the feet and legs. This evaluation may include assessment of the patient’s reflexes, ability to feel light
touch, and ability to feel vibration. In some cases, additional neurologic tests may be ordered.
1. First and foremost, treatment of diabetic peripheral
neuropathy centers on control of the patient’s blood sugar level. In addition, various options are used to treat the
2. Medications are available to help relieve
specific symptoms, such as tingling or burning. Sometimes a combination of different medications is used.
3. In some cases, the patient may also undergo physical therapy with anodyne treatments
to help reduce balance problems or other symptoms.
New relatively safe surgical techniques have been developed to relieve the neuropathy.
The patient plays a vital role in minimizing the risk of developing diabetic peripheral neuropathy and in
preventing its possible consequences. Some important preventive measures include:
Keep blood sugar levels under
Wear well-fitting shoes to avoid getting
Inspect your feet every day. If you notice
any cuts, redness, blisters, or swelling, see your foot and ankle surgeon right away. This can prevent problems from becoming
Visit your foot and ankle surgeon on a
regular basis for an examination to help prevent the foot complications of diabetes.
Have periodic visits with your primary care physician or endocrinologist. The foot and ankle surgeon
works together with these and other providers to prevent and treat complications from diabetes.
Line Up Front
Motor Neuropathy (Deformity)