Complications of Type 1 Diabetes

Abnormal function of the peripheral nerves is the most frequent long-term complication of type 1 diabetes and occurs in about 80% of the patients after 15-20 years.  It may be present in sub-clinical form already shortly after onset of diabetes, manifesting itself as a slowing of the velocity with which nerve signals are conducted.  In its most common form, diabetic neuropathy is symmetrical and affects the nerves to the feet and the lower legs.  Sensory nerve damage dominates the clinical picture with reduced sensibility, numbness, tingling sensations, reduced vibration, and temperature perception.  In some patients, pain is also present.  Neuropathy is a major initiating factor for diabetic foot disease resulting in foot ulcer formation, impaired wound healing and infection with chronic ulcer formation, and frequently requirement of surgical treatment.  Strict blood glucose control is recommended and medication for pain relief is available, but there are currently no therapeutic options for causal treatment or mitigation of diabetic neuropathy