Left Side

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Diabetes Complications: Nervous System

Peripheral

Diabetes may affect the nerves of the limbs, especially the lower limbs. This gives rise to tingling and numbness of the feet, a sensation of "pins and needles", usually worse at night, weakness of the legs and unsteadiness, due to the blunting of sensations. Loss of sense of pain and posture may give rise to disorganization of the small joints of the foot. Here, the foot is swollen but the pain is absent or minimal. Injuries to the feet may get unnoticed, giving rise to a sore on the sole of the foot (see Ch. 15).

Some diabetics may get sharp pain and weakness of the thigh muscles, making climbing the stairs difficult. Sometimes, diabetes may affect a single large nerve of the trunk. Temporary squint and double vision due to involvement of the nerve supplying the eye muscles have been described.

A warm (not hot) bath followed by a massage with an oil or lanolin helps to keep the skin of the feet supple. The pain in the limb, typically worse at night, can be relieved by drugs. Care of the feet is very important and is discussed in the following Ch. 15. Control of diabetes is essential.

Autonomic

Just as the limbs are supplied by nerves, the inner organs like the urinary bladder, the bowels, or the blood vessels or the heart also have a nerve supply. This part of the nervous system is not under the control of will and is called the autonomic nervous system.

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Left Side

Left Side

Diabetes Complications: Nervous System