People with diabetes feel like their feet are wearing "socks" and should beware of peripheral neuropathy

A diabetic patient complained to Huazi that he felt like he was wearing an extra pair of socks on his feet and was becoming less and less sensitive to pain and temperature. He went to a large hospital to see a specialist, who diagnosed him with diabetic peripheral neuropathy. What should he pay attention to and is there any treatment?

Huazi told him that almost all diabetic patients with a long course of illness have varying degrees of peripheral neuropathy. The initial symptoms are symmetrical burning and tingling sensations in the distal limbs, which then gradually develop upwards, with a "sock-like" or "glove-like" feeling.

1. Why does diabetes cause peripheral neuropathy? The mechanism of diabetes causing peripheral neuropathy has not been fully explained yet, and the main mechanism is the sorbitol accumulation hypothesis. When a normal human body metabolizes glucose, it will enter the tricarboxylic acid cycle through aerobic metabolism, or produce lactic acid through anaerobic metabolism. Only a small amount of glucose will be metabolized into sorbitol through bypass metabolism.

When the blood sugar level of diabetic patients cannot be controlled, it will lead to increased glucose metabolism through bypass, and a large amount of sorbitol will be generated through the action of aldose reductase, causing sorbitol to accumulate in blood vessels, nerves and other tissues, causing peripheral nerve damage. In other words, high blood sugar is the direct cause of peripheral nerve damage.

2. How to treat peripheral neuropathy 1. Control blood sugar: Controlling blood sugar at normal levels through diet control, increased exercise and the use of hypoglycemic drugs is the fundamental principle for preventing and treating diabetic peripheral neuropathy.

2. Nerve nutrition: Supplement vitamin B1, vitamin B6, folic acid and vitamin B12. It can promote nerve metabolism and neuron myelin synthesis, and also promote nerve axon regeneration. Methylcobalamin, a derivative of vitamin B12, is commonly used now. It is easier to enter nerve cells than vitamin B12 and has a better effect.

3. Fight against oxidative stress: Lipoic acid is an antioxidant drug that can reduce lipid oxidation in nerve tissue, inhibit aldose reductase, and reduce the production of sorbitol.

4. Reduce sorbitol production: The use of the aldose reductase inhibitor epalrestat can inhibit the production of sorbitol in diabetic patients, improve subjective symptoms and neurological dysfunction, and increase motor nerve conduction velocity and autonomic nerve function.

5. Improve microcirculation: High blood sugar can lead to microcirculation disorders and reduced blood supply to peripheral nerves, which is also an important factor causing peripheral neuropathy. Using drugs such as beraprost sodium, cilostazol, and pancreatic kallikrein to improve microcirculation and restore nerve blood supply can also improve the symptoms of peripheral neuropathy.

6. Relieve nerve pain: Peripheral neuropathy may cause pain symptoms, which is essentially nerve pain. Commonly used analgesics are ineffective, and pain relief treatment is required with drugs such as carbamazepine, gabapentin, and pregabalin to treat nerve pain.

3. Focus on preventing diabetic foot. Peripheral neuropathy caused by diabetes can lead to autonomic nerve disorders, dry skin, chapped skin, ischemia of the extremities, and loss of pain sensation in the feet. It is possible that ulcers, infections, and gangrene may occur in the feet that do not heal for a long time. Severe diabetic foot can cause systemic infection and even require amputation to save life.

To prevent diabetic foot, controlling blood sugar is the key. At the same time, you should quit smoking and drinking, maintain a healthy weight, and do more than 30 minutes of aerobic exercise every day. Wear shoes and socks that fit well to avoid squeezing your feet. Check your feet every day. If you find abnormalities such as cold skin, color changes, or ulcers, you should seek medical treatment in time.

In summary, if diabetic patients have poor blood sugar control for a long time, they are prone to peripheral neuropathy. Controlling blood sugar is the fundamental principle for preventing and treating diseases. For those who have already developed peripheral neuropathy, it is important to beware of diabetic foot and choose medications under the guidance of a doctor to control the condition. If you have any questions about medication, consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.