Neuropathy is the loss of sensation, and it is the number one disease that affects the diabetic that leads to loss of limb.
Neuropathy is usually characterized by phases:
- Phase I of neuropathy is a tingling sensation in the plantar aspect (bottom) of the foot that may manifest as a feeling of bugs crawling or bees stinging, and this term is referred to as formication. This is a very important indicator that loss of sensation is happening.
- Phase II has the symptoms that come more frequently and are more intense.
- Phase III is characterized by a constant burning of the feet that causes disruptions in sleep. This phase usually requires medication such as pain pills or other medications such as Neurontin.
- Phase IV is characterized by moments of relief. The patient is falsely convinced that their disease is improving because there are moments of lack of pain; but really what is happening is that the condition is progressing into Phase V, which is not total relief of pain but complete loss of sensation. This is the most dangerous phase and this is when ulcers develop.
New tests have been developed to measure the loss of sensation. There are several devices that are classified as quantitative sensory testing. The best and most informative of these tests is the pressure specific sensory device (PSSD). To find out more about this device check out these two web sites: http://www.neuropathyweb.com and http://www.dellon.com.
Vibratory threshold devices are also helpful in ascertaining whether or not loss of sensation is occurring. The Semmens-Weinstein monofilament is also a good screening device for loss of sensation on the plantar aspect of the foot.
When these conditions of loss of sensation are detected usually a neurologist, specially trained podiatrists or family doctor can treat this type of condition. The podiatrist is probably the first line of defense in the practitioner who treats the ulcerations that develop from this condition. It is important to seek out professional help before self-treatment. They will use devices to off-load the ulcerations, custom orthotics, diabetic shoes, antibiotics, foot soaks/baths and good diabetic hygiene.
Other useful treatments include massage, pain relieving gels, such as Neuro-Eze Neuropathy cream and Boswella Cream as affective relieve for neuropathic pain. Other treatments are vitamins such as Rodex Forte, and Dia Vite Vitamins.
The newest treatment for diabetic neuropathy from a medical standpoint is L-Arginine. A commercially available cream is NOW available … Neuro-Eze, and also oral use of L-Arginine. L-Arginine is a semi-essential amino acid and in diabetics the levels are very low. L-Arginine is one of the building blocks of protein and it goes through the L-Arginine nitricoxide oxygen pathway. If there is not enough L-Arginine, as a precursor, then the production of nitricoxide cannot be established therefore the nerve is deprived of oxygen (anoxia) and that is thought to be the reason for the pain development. There is also a surgical procedure that was devloped by Dr. Lee Dellon that has been shown to be very effective in restoring sensation in the diabetic limb.