Diabetic polyneuropathy: clinical picture and consequences

Diabetische Polyneuropathie: Krankheitsbild und Folgen

At first it just tingles in the feet, they sometimes hurt or feel numb. What is part of everyday life for many diabetics is a complication of diabetes that can have serious consequences: the amputation of one or both feet is certainly the most serious of these. Diabetic polyneuropathy is the name of this secondary disease, which can significantly affect not only the quality of life of diabetics.

1. Introduction: One in four affected?

Diabetic polyneuropathy is a common complication of diabetes, affecting about a quarter of all people with this metabolic disorder worldwide. Diabetic polyneuropathy develops when high blood sugar levels damage the small blood vessels that supply nerves with nutrients.

Diabetes mellitus is a condition in which the body is unable to properly regulate blood sugar. This can lead to chronically high blood sugar levels, which over time can cause various health problems, including diabetic polyneuropathy.

Definition: Diabetic polyneuropathy

Diabetic polyneuropathy is a peripheral neuropathy that occurs as a direct consequence of chronic hyperglycemia resulting from uncontrolled diabetes mellitus. It is characterized by bilateral and symmetric degeneration of peripheral nerve fibers, mainly sensory and autonomic nerves, which can result in a variety of symptoms ranging from pain and numbness in the extremities to dysfunction of the internal organs.

Put simply, this means: diabetic polyneuropathy is a disease that occurs in people with diabetes. It occurs when high blood sugar damages nerves in the body over a long period of time. This usually affects the nerves in the legs and feet. As a result, sufferers can often feel tingling, numbness, or pain. Sometimes the disease also affects nerves that control internal organs. Without proper control, this disease can cause very serious problems, such as wounds, infections, or even the removal of a body part.

2. Statistics and societal impact of diabetic polyneuropathy

Diabetic polyneuropathy affects millions of people worldwide and causes significant health and economic burdens. As the prevalence of diabetes has increased, so has the number of people living with this complication.

Current research efforts are focused on new ways to treat and prevent diabetic polyneuropathy, including improving glycemic control and developing new drugs.

3. Development of diabetic polyneuropathy

Diabetic polyneuropathy develops when nerves are damaged by persistently high blood sugar levels. This damage can slow down or block the signals that nerves send. Peripheral nerves, which carry signals between the brain and the rest of the body, are most commonly affected. Peripheral nerves are nerves that are located outside of the brain and spinal cord. They are part of the peripheral nervous system, which transmits signals between the central nervous system (brain and spinal cord) and the rest of the body. The most likely affected parts of the body are the feet.

4. The role of glycemic control in diabetic polyneuropathy

A high blood sugar level over a long period of time is decisive for the development of polyneuropathy in diabetic patients. Therefore, controlling blood sugar is crucial for the prevention and management of diabetic polyneuropathy. Well-regulated blood sugar levels can help prevent or delay nerve damage.

5. How does diabetic polyneuropathy manifest itself

The symptoms of diabetic polyneuropathy can vary and depend on the nerves affected. They can include tingling, numbness, burning or pain, typically in the legs or feet - around one in four people with diabetes will develop these symptoms. In some cases - in what is known as autonomic diabetic polyneuropathy - the internal organs can also be affected, which can lead to digestive problems, heart problems and other symptoms.

6. Diagnosis and consequences of diabetic polyneuropathy

The diagnosis of diabetic polyneuropathy is based on the patient's symptoms and a physical examination. The suspected diagnosis of polyneuropathy is usually made by the general practitioner. This is where the first interview and usually also a first physical examination takes place. Additional tests can measure nerve conduction velocity or examine nerve function more closely.

The final diagnosis is usually made by a doctor specializing in neurology, i.e. the specialty of neurology.

Left unchecked, diabetic polyneuropathy can lead to serious complications. These include ulcers and infections on the feet, which in severe cases can even lead to amputations. In addition, the pain and discomfort associated with diabetic polyneuropathy can significantly impact quality of life.

7. Treatment of diabetic polyneuropathy

Monitoring of diabetic polyneuropathy primarily focuses on controlling blood sugar and relieving symptoms. Because there is no cure, but ways to relieve the pain and prevent further damage. In diabetic polyneuropathy it is important to have good blood sugar control. Good blood sugar control reduces the risk of neuropathy. The national care guideline for neuropathy in diabetes in adults describes drug-based pain therapy for sensorimotor diabetic polyneuropathy. This may include medication for pain relief, physical therapy, and other approaches. In some cases, lifestyle changes, including a healthy diet and regular physical activity, can also help.

8. The importance of early detection in diabetic polyneuropathy

Early detection of diabetic polyneuropathy is crucial to start treatment and avoid serious complications. People with diabetes should therefore be regularly checked for signs of neuropathy.

A new approach to early detection of complications of diabetic polyneuropathy is the development of smart insoles. It relies on sensitive sensors to measure the temperature of the sole of the foot and detect differences of as little as 0.1 degrees Celsius. This allows the insoles to identify potential problem areas before they lead to serious complications, since the temperature of the sole of the foot can be an important indicator of injury in diabetic polyneuropathy. Damage to the peripheral nervous system often reduces the sensitivity of the feet. As a result, injuries can go unnoticed and worsen.

Smart insoles offer an innovative way to monitor foot health. By recording temperature changes, an early warning of possible complications of diabetic polyneuropathy can be given.

9. Technological details insole

The insoles use precise sensors to record temperature differences of 0.1 degrees Celsius. If a difference persists for more than 48 hours, a dedicated app notifies the wearer so timely action can be taken.

10. A task for the relatives: importance of educating and raising awareness of diabetic polyneuropathy

Education and raising awareness of diabetic polyneuropathy and its possible complications is of crucial importance for early detection and a course that maintains a high quality of life. Better education can help people with diabetes take the necessary steps to prevent and treat the condition. This also includes regular temperature monitoring of the feet as support for daily checks.

What is the purpose of measuring the temperature of the feet?  

Elevated temperature values ​​can indicate possible incipient inflammation, which can lead to complications in patients with diabetic foot syndrome, for example. In addition to daily foot checks, several studies have shown the positive effects of regular plantar temperature measurements.  

The studies mentioned below were not carried out with intelligent shoe inserts.  

The first indications of this came as early as 1975 in a study by Bergtholdt and Brand .  

The International Working Group on Diabetic Foot (IWGDF) led by Prof. Dr. Bus has already included regular foot temperature checks as a recommendation in its guidelines .  

Further studies indicate that over 70% (sometimes even over 90%) of foot complications were detected early by temperature measurements.  

How can the intelligent shoe inserts from osentec support?  


The intelligent shoe inserts from osentec use tiny sensors to measure the temperature of the soles of the feet and detect differences from as little as 0.1°C. The associated app compares the recorded values ​​with each other and sends a message as soon as the temperature differences last longer than 48 hours. In this way, we support the initiation of measures at an early stage and thus a preventive reaction to possible ulcers and wounds.

We would be happy to advise you on the advantages of an accompanying measure using our intelligent shoe inserts. Visit our osentec website for more information on how the insoles work and how they can contribute to well-being. you can reach us at info@osentec.de and by telephone on 0395 3511 6213.