Almost every second diabetic will develop detectable neuropathy in 10 years
Treatments for neuropathic pain have limited effects only
A person with diabetes has 15-46% higher risk of lower extremity amputation
8 December 2022; Ras Al Khaimah, UAE: Diabetic neuropathy and the resultant diabetic foot remain among one of the more serious complications of uncontrolled blood sugar levels in the human body. 40-50% of diabetics develop detectable neuropathy within 10 years of the onset of diabetes. During the latest ‘Diabeat' webinar by RAK Hospital on ‘Diabetic Neuropathy & Diabetic Foot' organized as part of the RAK Diabetes Challenge 2022 informative series, Dr. Sweta Adatia, Specialist Neurologist at RAK Hospital emphasized the need for prevention while discussing in detail a holistic management approach towards Diabetic Neuropathy and Diabetic Foot.
Diabetic neuropathy refers to continuing nerve damage due to constantly high blood glucose levels. The changes are slow and noticeable only after having caused considerable damage. Diabetes-led neuropathy is clinically classified as peripheral (feet and legs mainly), autonomic (digestive system, blood vessels, urinary system and sex organs), proximal (usually one side of thighs, hips and buttocks) and focal (specific nerves of head, torso and feet). The last session of the webinar series focused chiefly on the foot complications of peripheral diabetic neuropathy.
“The data is indeed alarming”, Dr Adatia stated. Nearly 85% of all amputations are preceded by a non-healing foot ulcer. Moreover, a person with diabetes mellitus has a 15-46% higher risk of lower extremity amputation versus a non-diabetic.
Lower extremities i.e. the legs and feet are impacted most, with patients complaining about pain, tingling sensations and a feeling of numbness. These complications cause a significant drop in the overall quality of a patient's life and treatments never bring complete relief. Pain becomes a constant companion and the risk of foot ulceration and amputation increases manifolds. Uncontrolled hyperglycemia, duration of diabetes, old age, smoking, peripheral vascular disease etc. are some of the chief risk factors.
Emphasizing the importance of a preventive lifestyle, especially amongst those at high risk of diabetes or associated complications, she also underscored the importance of regular screening of the foot for any injury or unusual changes related to skin, bone, blood vessels or nerves. She educated the participants about the choices of screening options as well as the recommended frequency of such check-ups based on clinical assessment of patients' conditions and medical history. For low-risk patients, she also recommended the “Ipswich- touch the toe” test - a screening exercise so simple that everyone could do it at home.
Participants were also provided with an elaborate guideline on essential “Do's & Don'ts” of foot care, which besides entailing the description of ideal footwear offered suggestions on a dietary regimen too for the prevention of diabetic neuropathy. All these suggestions were easily relatable and doable, for example – daily monitoring of feet for cuts, cracks, bruises, blisters, sores, infections, unusual markings etc. or daily washing and drying of feet, especially between the toes, etc.
Commenting on the subject, Dr Raza Siddiqui, Executive Director, RAK Hospital said, “While an effective glycemic control is critical for clinical management of diabetic neuropathy, the importance of multi-disciplinary approach & team-work must never be undermined. A coordinated engagement of endocrinologists, Orthotist, Podiatric surgeons, Dieticians, Physiotherapists and Counselors enables us to manage diabetes in a far superior manner. At the same time, it's equally vital that society too is continually sensitized about the importance of prevention over treatment along with the range of treatment options available to them. Towards this end, the ‘Diabeat” series of webinars would continue empowering society with the awareness & knowledge essential to build a healthier today and tomorrow.”