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One of the most common complications of diabetes is diabetic neuropathy that can
be painful and disabling. Neuropathy means damage to the nerves that run
throughout the body, connecting the spinal cord to muscles, skin, blood vessels,
and other organs. Diabetic neuropathy is a group of nerve diseases that affect
the peripheral nerves (there are three types of peripheral nerves: motor,
sensory, and autonomic).
- Neuropathy is more likely to affect people who have had diabetes for a
long time or whose glucose control is poor.
- About 60% to 70% of people with diabetes have mild to severe forms of
nervous system damage (which often includes impaired sensation or pain in
the feet or hands, slowed digestion of food in the stomach, carpal tunnel
syndrome, and other nerve problems).
- Severe forms of diabetic nerve disease are a major contributing
cause of lower extremity amputations.
- More than half of lower limb amputations in the United States occur among
people with diabetes.
- From 1993 to 1995, about 67,000 amputations were performed each year among
people with diabetes.
The most important factor leading to amputation for the person with diabetes
is peripheral neuropathy and the resulting insensate foot. This leads to
painless trauma, ulceration, infection, and finally amputation. Because of the
lack of pain, the patient with a foot ulcer is lulled into a false sense of
security, perceiving the ulcer to be of little or no significance. Thus, the
patient neglects and/or delays appropriate treatment for their problem. Because
peripheral neuropathy leads to a high risk for an insensitive foot, the patient
must be made aware of the importance of the loss of sensation
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