Peripheral Nervous System Involvement in Diabetes and Role of Rehabilitation

Diabetes neuropathy (DN) is a growing concern with increased morbidity and mortality. The swings in blood sugar and high blood sugar damage both the vasculature and the nerves contributing to the disease and depending on the sites of injuries, can manifest with four different presentations: peripheral, focal, proximal and autonomic.

Initial evaluation can consist of thorough history and physical exam with laboratory testing, electromyography, biopsy and imaging if indicated. Treatment is focused on strict glycemic controls, symptom control through medication and therapy to improve quality of life and safety. Occupational and physical therapy should be considered in all patients with moderate to severe DN.