What problems can be caused by diabetic neuropathy ?
Neuropathy can result in two sets of what superficially appear to be contradictory problems. Most patients who have neuropathy have one of these problems but some can be affected by both. • loss of ability to feel pain and other sensation which leads to neuropathic ulceration. • symptoms of pain, burning, pins and needles or numbness which lead to discomfort (see section on Painful Neuropathy). A typical neuropathic ulcer is shown in the figure below. Patients with neuropathy lose their sensation of pain. As a result, they exert a lot of pressure at one spot under the foot when they walk, building up a callus at that site without causing discomfort. The pressure becomes so high that eventually it causes breakdown of tissues and ulceration. The patient hardly notices any pain. Therefore a typical neuropathic ulcer is : • painless • surrounded by callus • associated with good foot pulses (because the circulation is normal) • at the bottom of the foot and tips of toes Please note if neuro
