![]() ![]() We used a retrospective clinical database of 547 Japanese patients with diabetes mellitus who had their peripheral neurological findings assessed between 20. The aim of the current study was to compare the vibratory sensations assessed by a 128‐Hz tuning fork at different sites in Japanese diabetic patients. It would be of clinical use if the assessment at some alternative sites was clinically validated. In addition, some diabetic patients will suffer from foot lesions at the very site where it is generally recommended to carry out the neurological assessment. However, to date, few data are available about the association between the test at the medial malleolus and at the great toe in Japanese diabetic patients, which has made it difficult to compare the reports from Japan and those from overseas about vibratory sensation. In Japan, vibratory sensation in diabetic patients is often assessed with a 128‐Hz tuning fork at the medial malleolus 8, whereas it is often assessed at the great toe overseas 4. In clinical practice, diabetic peripheral neuropathy is evaluated by the combination of several examinations, including the assessment of vibratory sensation 4. Its periodic assessment is clinically important in the management of diabetes mellitus. It is not only associated with unpleasant symptoms, which impairs quality of life, but is also associated with diabetic foot, resulting in tissue loss and amputation 4. It is very important for people with diabetes not only to be seen regularly by their primary care doctor and endocrinologist, but also to be followed closely by a podiatrist.Īt Westside Podiatry, our team of podiatrist excels in caring for our patients with diabetic issues.Peripheral neuropathy is a major complication of diabetes mellitus 1. This is a large problem because if a patient with diabetes develops a wound, often due to lack of feeling, and has poor vascular supply to their feet, then they may have trouble healing this wound.Īs one can see, diabetes is not only a problem with blood sugar, but involves many different organ systems. ![]() Peripheral vascular disease is a complication of diabetes, and means that there is poor blood flow to the feet. Patients with neuropathy may also develop what is called peripheral vascular disease. This is seen in the skin of the feet when the skin becomes very thin and often very dry due to the loss of autonomic control. Nerves also provide temperature (autonomic) control and many people with diabetes may have an autonomic component to their neuropathy as well. This can lead to areas of abnormal pressure in your shoes which the patient won’t feel (due to sensory neuropathy) and can lead to sores and ulcerations. Patients with motor neuropathy may develop bony protrusions in areas on their feet. Due to the death of the nerves, the muscles in the feet begin to waste. Motor neuropathy involves loss of motor function (movement) in the extremity. Our nerves also provide motor function (muscles need nerves to work properly). When people have painful neuropathy, not only are they losing feeling in their feet, but as the process develops, they also have severe burning pain which can keep them awake at night. Thus, these injuries can go undetected and lead to much more serious problems.Īdditionally, some people with diabetes may develop painful neuropathy. Without feeling in the extremity, patients can injure their foot or cut their foot, and not know due to lack of feeling. There are many patients who can be touched with the tuning fork or wire and not feel a thing. Podiatrists use different techniques to measure loss of sensation including tuning forks and a monofilament (a small thin wire). This is usually symmetrical in nature and generally non-reversible. Sensory neuropathy involves loss of sensation in the extremity. Many people think that neuropathy only involves the loss of sensation in their feet, but your podiatrist knows that this is only part of the problem. If not treated, it can progress rapidly and ends up involving the entire foot. This usually begins in the feet, at the end of the toes, due to the fact that this is the part of the body furthest from the heart. Sorbitol accumulation blocks nerve function which can lead to neuropathy. Neuropathy is defined as nerve damage or loss. People with diabetes who have high blood sugars for long periods of time can develop nerve damage due to the accumulation of sugar hi-products (called sorbitol). ![]() This is largely due to the development of neuropathy. ![]() Many people with diabetes develop problems with their feet. Diabetes not only effects a patient’s blood sugar, but people with diabetes can also have trouble with their kidneys, heart, and of particular interest to podiatrists, their feet. Unfortunately, controlling your blood sugar is not the only long term worry that we have when treating diabetes. Millions of people are diagnosed with diabetes each year. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |