Diabetic Neuropathy

Quick answer

Diabetic neuropathy is nerve damage caused by diabetes. The most common form hits your feet and legs first, then your hands and arms. You may notice burning or tingling, sharp pains or cramps, muscle weakness, or a loss of balance. The bigger danger is numbness. If you cannot feel pain or temperature, a cut can turn into a foot ulcer without you knowing. Many patients also have poor circulation alongside the nerve damage.

Diabetic neuropathy is a common complication of diabetes and can affect many aspects of life and severely limit patients’ daily functions. Diabetic neuropathy is defined as “the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes.” Those being is mainly Diabetic vasculopathy or peripheral vascular disease (PAD).

At CACVI, we have over 30 years of experience performing more than 15,000 vascular and cardiac procedures. We are also committed to providing compassionate and personal care.

Types of Diabetic Neuropathy

Some types of diabetic neuropathy are:

1. Peripheral Neuropathy: It is the most common form of diabetic neuropathy. For this, your feet and legs are often affected first, followed by your hands and arms. Symptoms may include numbness or reduced ability to feel pain or temperature changes, a tingling or burning sensation, sharp pains or cramps, muscle weakness, loss of reflexes, loss of balance and coordination, and serious foot problems.

2. Autonomic Neuropathy: This type of diabetic neuropathy affects the nerves that control your heart, regulate blood pressure, and control blood glucose levels. It also affects other internal organs, causing problems with digestion, respiratory function, urination, sexual response, and vision.

3. Proximal neuropathy (Diabetic Polyradiculopathy): Here, the nerves in the thighs, hips, buttocks, or legs are affected. It can cause severe pain in any of the aforementioned areas and lead to weakness in the legs.

What Are The Symptoms Of Diabetic Neuropathy?

Neuropathic pain is often described as a burning sensation and affected areas are often sensitive to the touch. Symptoms of neuropathic pain include excruciating pain, pins and needles, lack of coordination and falling, muscle weakness, and numbness. Often times diabetic vasculopathy symptoms overlap the neuropathy symptoms.

More than 50% of people with type-1 diabetes mellitus will experience nerve damage (neuropathy). Diabetes neuropathy may lead to impotency and foot ulcers, which the latter will further lead to infections and amputation. The direct effect of long-term hyperglycemia which is seen in Type I diabetes or common poor sugar control in Type-II diabetes causing decreased blood flow will damage nerves.

Complications of Diabetic Neuropathy

The damage caused by this diabetic neuropathy can result in both acute and long-term complications. Some of these complications can significantly impact quality of life and increase the risk of further health issues. They include:

Foot Complications: Due to numbness in the feet, cuts and blisters can go unnoticed and become infected or develop into diabetic foot ulcers. Severe cases may lead to necrosis (tissue death) or gangrene, potentially requiring foot or leg amputation. Diabetic neuropathy also contributes to changes in the shape of the feet and toes.

Infections: The nerve damage can lead to a decreased sensation, making it harder to notice injuries or infections. Minor cuts and injuries can quickly become serious infections without prompt treatment.

Charcot Joint (Neuropathic Arthropathy): This condition can occur when a joint deteriorates because of nerve damage. Charcot joint primarily affects the feet and can cause deformities and lead to disability.

Urinary Tract Problems: Neuropathy can affect the bladder. This leads to incomplete bladder emptying, urinary tract infections, and urinary incontinence.

Digestive Issues: Gastroparesis is a condition where the stomach empties too slowly, which can cause nausea, vomiting, bloating, and loss of appetite. Diabetic neuropathy can also lead to constipation, diarrhea, and incontinence.

Sexual Dysfunction: Men may experience erectile dysfunction due to damaged nerves and blood vessels, while women may experience vaginal dryness and difficulties with arousal and orgasm.

Hypoglycemia Unawareness: Damage to the nerves that manage blood glucose levels can mask the warning signs of hypoglycemia (low blood sugar), making it a dangerous complication.

Cardiovascular Problems: Autonomic neuropathy can affect the nerves that control the heart and blood vessels. Thus, leading to changes in blood pressure and heart rate, and an increased risk of heart disease, and stroke.

Sweating and Skin Problems: Nerve damage can affect sweat glands, leading to abnormal sweating, dry skin, and foot problems.
Mood and Quality of Life: Chronic pain, mobility issues, and other complications associated with diabetic neuropathy can affect mental health. This leads to depression and anxiety.

How to manage Diabetic neuropathy?

Get early screening of Diabetic Vasculopathy and Neuropathy at CACVI.
Foot care, including daily checks, cleaning, moisturizing, trimming toenails, wearing clean and dry socks and cushioned, well-fitting shoes.
Many diabetic neuropathy patients actually have diabetic vasculopathy with severe venous insufficiency and peripheral arterial disease.

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A little blonde Russian woman named Natasha asked me to post about her renal procedure. It was done by Dr. Khorsandi at CACVI. They took absolutely amazing care of her and went above and beyond to treat her terribly high blood pressure. They lasered her renal artery. After the procedure it wouldn’t stop bleeding so they ended up staying w her at the center until 9pm. That’s when they finally had to call the ambulance to move her to E.R. All of the staff were incredibly professional and their care was second to none. Dr. Lala promised her that her high blood pressure would go away. It has and now she’s throwing out all her old med’s just like Lala promised. This group of Doctors is like no other. If you have any of these cardiac issues then you’ve found your saving grace. No need to look any further. They were incredibly patient and helpful in every medical way possible. Natasha has found a new way of living. Without her terrible pounding migraines she had on a daily basis. 5 stars all the way. They deserve all the praise possible. They provided a miracle. Thank you Dr’s Lala & Khorsandi.

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On behalf of my father, a patient of CACVI, I wanted to acknowledge and praise the entire team of this organization for its outstanding surgical expertise and knowledgeable/warm supporting staff. We had gone through countless recommendations that all claimed there was only one last option for treatment, amputation. That news is devastating for anyone to hear, and resulted in my father having little faith that the quality of his life would ever be the same... All that changed the moment we had our first interaction with this organization. The care, knowledge, and most importantly hope that there was still options if we acted fast was single moment that turned this entire nightmare around. Thank you CACVI for being the single most important piece to solving my father's health crisis. Dont think twice, make the appointment and atleast go meet and see them-- for us it was the moment that changed the trajectory of our situation forever for the better.

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I’m 41 years old, and I have something called May-Thurner’s Syndrome. However, it wasn’t until I saw Dr. Vasim Lala a couple years ago that I was diagnosed with it. May-Thurner’s syndrome is when the main veins that split off into your legs is compressed by the main arteries that split off into your legs. The result is that the blood that should be coming back up through the leg veins pools at your ankles. My whole life until I was diagnosed, I was lethargic. My legs felt heavy. I started to develop purple bruising around my ankles in my twenties. I started to get varicose veins on my calves. I thought this was normal. I was living on “hard mode” and didn’t know it. If I was on my feet for extended periods of time, my legs would swell a lot. I thought maybe I need to lose some weight. When I started teaching a few years ago, I would be on my feet 6-8 hours a day. One day, I got home, and my left leg was so swollen my wife was concerned I had a blood clot. I went to the emergency room, and thankfully it was just superficial. I temporarily went on blood thinners and was recommended to see Dr. Lala. He changed my life. I’d shown my purpling ankles to GP’s. They’d seen my varicose veins. But none if them put all the signs together until I saw Dr. Lala. He diagnosed me with May-Thurner’s syndrome and recommend we put stents in my veins to prevent them from being compressed by the arteries. So we did the surgeries. Out patient procedures. My legs stopped swelling a lot. I started wearing compression socks. I had to be on blood thinners for a year, but eventually I was able to stop taking them which was great. But I still had varicose veins in my legs because they had widened from the blood pooling in them for years. I’ve had two ablations per leg since them, which closes the affected veins, and I’ve got a new lease on life. My legs feel lighter. They don’t swell nearly as much. The varicose veins have disappeared. Now, I’m lighter on my feet. I’m not lethargic. There’s a pep in my step. I have one more ablation each being scheduled. I’m thankful for Dr. Lala and his incredible team at CACVI for their diagnosis and treatment. It truly changed my life.

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Dr. Moinakhtar Lala and Dr. Mehran J. Khorsandi of CACVI

Dr. M Lala, Dr. Mehran J. Khorsandi and Dr. V Lala

Meet Your Specialists

The Center for Advanced Cardiac and Vascular Interventions (CACVI) is led by Dr. M Lala, Dr. Khorsandi, and Dr. V Lala, who have over thirty years of practice with over 15,000 vascular and cardiac procedures performed. Our physicians are determined to provide each patient with experienced, compassionate care as they work diligently to improve your health.