Diabetes has become a global public health problems with millions of affected people. The condition can cause damage to blood vessels and nerves, leading to a loss of sensation known as peripheral neuropathy. The loss of nerve among diabetic patients in their feet and legs typically develops over time. As patients cannot feel foot injuries as acutely as those without diabetes, they may inadvertently ignore foot problems. Therefore, pain is not an early indicator of problems in diabetic patients. Poor circulation and decreased immunity to infection can also lead to serious diabetic foot problems.
Symptoms of diabetic foot problems include pain or a tingling foot sensation in the feet at night. Ulcers, infections, and other problems may be painless. As a result, routine self-inspection of each foot is of utmost importance. Additionally, patients may experience unsteadiness in standing and walking due to the loss of sensation.
A study involving 13,000 patients, with type 2 diabetes revealed that lack of sensation in feet may predict heart and circulation problems. Testing for peripheral neuropathy may be a simple clinical way of identifying high risk diabetic individuals and may act as a preventative measure for heart attack and strokes.
Jack Brownrigg, a PhD student at St George’s, University of London, who conducted the research at St George’s Vascular Institute, said: “While the risk of cardiovascular disease is known to be higher in patients with diabetes, predicting which patients may be at greatest risk is often difficult. “We looked at data on individuals with no history of cardiovascular disease and found that those with peripheral neuropathy were more likely to develop cardiovascular disease.”
Robert Hinchliffe, Senior Lecturer and Consultant in Vascular Surgery at St George’s who co-led the study with Professor Kausik Ray, said: “While loss of sensation in the feet is known to be a key risk factor for foot ulcers, it may also provide additional useful information to guide patient management. This is the first study to show that it can also indicate an increased risk of cardiovascular problems like heart attacks or strokes. The good news is that peripheral neuropathy can be easily identified by simple tests carried out in GP surgeries. The results of the study warrant further investigation as to whether even greater control of risk factors including blood pressure and blood sugar can prevent or delay the onset of cardiovascular disease”.
J. R. W. Brownrigg, S. de Lusignan, A. McGovern, C. Hughes, M. M. Thompson, K. K. Ray, R. J. Hinchliffe. Peripheral neuropathy and the risk of cardiovascular events in type 2 diabetes mellitus. Heart, 2014; DOI: 10.1136/heartjnl-2014-305657