A Review of the Pathophysiology and Clinical Sequelae of Diabetic Polyneuropathy in the Feet

Diabetic neuropathy (DN), affects approximately 50% of the people who have diabetes mellitus. It is also the ubiquitous aspect of diabetes mellitus that is a precursor to decreased quality of life and limb threatening complications from diabetes. The vast majority of patients who develop a diabetic foot ulcer (DFU) are neuropathic and all patients who develop Charcot Arthropathy are profoundly neuropathic. Neuropathy can range from hypoesthetic (decreased sensation) to anesthetic to painful. Painful neuropathy is typically associated with small fiber neuropathy and affects approximately 20% percent of patient with neuropathy and will dramatically affect patient daily quality of life. However, hyopesthetic neuropathy is the leading cause of ulceration, Charcot Arthopathy and amputation. This article aims at reviewing the epidemiological relevance of DN as well as its pathophysiology and a brief review of diagnosis, and assessment as well as its sequelae.