Diabetes Complications: Neuropathy

Diabetes stands as one of or the very mos common causes of neuropathy, specifically the forms of neuropathy frequently called diabetic neuropathy or peripheral neuropathy.
Diabetic neuropathy roots solely from the diabetic condition rather than external injury or toxin exposure or infection. Diabetes is just one of a number of metabolic disorders that can lead to neuropathy. Diabetes is at its core a major metabolic disorder. Neuropathy is all but inevitable in diabetes.
Peripheral neuropathy is nerve damage away from the brain and spine, which form the center of the nervous system. The nerves are damaged. With diabetics, reduced circulation–also a near inevitability–causes the nerve damage. In my experience, doctors downplay the inevitabilities of diabetes because they are afraid patients will too quickly resign themselves to the eventualities without ever truly trying to take care of themselves. These problems are nearly inevitable, but the lack of self care will bring the problems sooner rather than later. I seek to communicate more honestly than doctors have by my experience, but am not dispensing medical advice. Nor do I think much of anyone who gives in to the negatives without a fight. "Inevitable" should never be interpreted as "immediate."
The nerve damage can affect sensations of temperature and pain. Neuropathy causes pain and numbness, most frequently in the hands and feet. This is the source of foot problems and high risk for them among diabetics. If the diabetic cannot feel pain in his feet, he can be unaware of injuries. Ignorance of bone problems most often results in my friend Charcot Foot. The more common risk that plays out is infections from cuts, punctures and abrasions on the feet that the diabetic cannot feel. Diabetics should wear socks and shoes at all times in an effort to prevent avoidable problems. Yet, as always with this miserable conditions, the patient must also take precautions with the precautions. Socks should not be so tight as to reduce circulation. Shoes should be well fitted, neither tight enough to cut into the feet nor loose enough to cause friction burns and abrasions. Shoes should never be worn without socks. Open wounds caused by shoes can be the most sinister; their gradual development makes them the easiest to not realize you have caused.
I learned one thing about neuropathy in a hard way that almost cost me my life. The neuropathy and generalized reduced diabetic circulation in my feet have made "toe testing" of water temperatures completely unreliable. On a friend’s boat a few years back, I had sat in the back with my feet in the water. It didn’t seem that cold. I dove in. The water was cold, so cold it triggered shock. I almost drown. Conversely, bath water might be much hotter than the diabetic toe can judge. Always check with an elbow rather than an extremity.
The neuropathy topic directly bridges into the running blood sugar testing topic. Please note the information from earlier in this post, a very subtle point in the overview: "Diabetic neuropathy roots solely from the diabetic condition rather than external injury..." Medical professionals probably will not point out to you that all the finger pricking of traditional home testing is likely to advance or cause neuropathy in the patient’s fingertips. You cannot keep sticking lancets into your fingertips without causing nerve damage on some level. This, and not the discomfort, prompted the recent push for non fingertip testing. Some sources on the net do not cite better than the 10% inaccuracy of arm testing than the patient could see with urine testing.
This risk to the fingertip nerves stood as one of my rationalizations against hopping on the home meter testing bandwagon. Again I warn: I have managed my diabetes with care, but in contrast to modern preferences and standards. I recommend anyone reading this to have frank conversations with their doctors before just doing what I do, and recent Type 2 diagnoses will require some form of home testing.