Diabetic Nerve Problems: Improving Health Outcomes

Larry Greenblatt, MD

Diabetic peripheral neuropathy (DPN) is a common condition which can cause pain, tingling, or numbness in the feet and legs. Most of the time primary care providers and endocrinologists can check for DPN and treat it when it becomes a problem. In addition, neurologists can play a crucial role in addressing the growing problem of diabetic peripheral neuropathy among individuals with diabetes. Dr. Eva Feldman, a professor of neurology at the University of Michigan, highlighted this issue at a recent medical conference. DPN has become more prevalent due to the rise in obesity and type 2 diabetes, with around 27% to 42% of people with diabetes estimated to have DPN in the United States.

Dr. Feldman emphasized the importance of neurologists in managing DPN by checking the body mass index (BMI, a measure of how heavy a person is relative to their height) and blood pressure of patients and recommending exercise routines. DPN is a significant public health concern, leading to a decrease in the quality of life, disability, or pain for many of those affected. It also poses an economic burden, costing approximately $6 billion annually in the United States. Moreover, the obesity pandemic contributes to metabolic syndrome (increased blood pressure, cholesterol problems, and resistance to the effect of insulin) and raises the risk of dementia for people with diabetes.

Common symptoms of DPN include numbness and loss of sensation in the extremities, which can be severe enough for patients not to feel injuries, such as cuts or scrapes on their feet. Dr. Feldman encourages neurologists to focus on disease prevention and help patients achieve better metabolic health through lifestyle changes. This includes addressing weight management, blood pressure control, physical activity, and diet, with research suggesting that aerobic exercise and specific dietary choices can improve or even help prevent DPN. Collaboration with other medical specialties is also recommended to provide a holistic approach to care for individuals with diabetes and DPN.

For more information: https://www.medscape.com/viewarticle/998723