Diabetic Neuropathy (or Polyneuropathy)
Diabetic neuropathy or general polyneuropathy is a condition where because of either diabetes or other conditions the nerves in the body start degenerating. As the nerves are dying the patient starts feeling numbness and tingling which typically starts in the distal feet and progressively gets worse. In progressive conditions it may also involve the hands where the numbness starts distally and then starts getting more and more dense and starts moving up into the arms and legs. A common complaint is a feeling of walking of eggshells or pebbles and patients with diabetic polyneuropathy with neuropathic pain generally complain of increased discomfort at night with the bed sheets bothering their feet.
Treatment consists of appropriate physical rehabilitation in combination with various antidepressant and anti-seizure medications, which are reasonably effective in calming down this pain in most patients. Appropriate shoes are recommended to prevent ulcer formation in the insensate feet, which may result in amputations if not cared for appropriately. The end result of appropriate treatment is reasonable pain control and increased comfort in most patients with better quality of life. Diagnosing the underlying reason for polyneuropathy is the key in helping a significant number of these patients and can be done in association with neurologists who work in partnership and as an extra resource with Dr. Rehman in evaluating and treating these conditions so that the patients get the best care possible.