Is there a link between foot sensation and complications in Diabetic Peripheral Neuropathy?

In people with diabetic peripheral neuropathy (DPN), the ability to feel sensations in the feet—known as protective sensation—is a critical indicator of health. When this sensation is diminished or lost, it can lead to more severe physical complications because the body cannot detect minor injuries that could lead to serious infections.

What the research says

Research shows a clear link between the loss of protective sensation and increased risk for severe outcomes. A study of 387 patients with DPN found that those who lost their protective sensation (LOPS) had significantly higher rates of active ulcers, amputations, and osteomyelitis (a bone infection) compared to those who only had reduced sensation ⁵.

Several factors are associated with a complete loss of protective sensation. These include a history of smoking, previous foot ulcers or amputations, and severe chronic kidney disease (CKD) ⁵. Additionally, patients with LOPS showed higher rates of dyslipidemia (high blood fats) and higher HbA1c levels, which reflects poorer long-term blood sugar control ⁵.

Physiologically, DPN involves complex issues like inflammation and damage to nerves caused by high blood sugar and other metabolic stresses ². These conditions can lead to both hypoesthesia (reduced sensation) and hyperalgesia (increased sensitivity to pain) ². While some treatments focus on managing the pain associated with these nerve issues, maintaining protective sensation is vital for preventing physical injury to the feet ⁴⁵.

What to ask your doctor

• What is my current level of protective sensation in my feet?
• Am I at high risk for foot ulcers or other complications based on my nerve health?
• How does my kidney function or blood sugar control affect the health of my nerves?
• What specific signs should I look for that indicate a loss of protective sensation?