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Diabetic neuropathy is a microvascular complication of type 1 and type 2 diabetes that affects the nervous system and leads to disability. The first signs of neuropathy are tingling, numbness and itching of the hands and feet. Diabetic neuropathy affects 60–70% of diabetics and is a major cause of foot ulceration and amputation.

Symptoms of diabetic neuropathy
The most common symptoms of diabetic neuropathy:
• sensory disturbances, hyperalgesia, hypersensitivity to touch, loss of sensation in the feet,
• numbness, tingling, burning of hands and feet,
• feeling very hot or very cold feet,
• pain in the feet:
- burning pain, superficial
- deeply localized, rapid, dull pain in the bones of the feet that occur most often at night,
- sudden stabbing pain
• leg cramps
• decrease in muscle strength, muscle atrophy,
• impairment of autonomic functions (decreased sweating, dry and cool skin, cold feet, difficult to heal wounds, ulcers, women may have vaginal dryness, decreased sex drive, and men may have erectile dysfunction.
Diabetic neuropathy reduces the quality of life of patients. This disease is the cause of so-called diabetic foot syndrome and leads to gangrene and ultimately loss of limb. According to statistics, as much as 50-75% of amputation of limbs falls on the diabetic foot.

Causes of diabetic neuropathy
The main cause of diabetic neuropathy is hyperglycemia, i.e. elevated blood glucose, which causes disorders in the structure of nerve fibers and a disorder of their function, which is the conduction of nerve impulses.
Other factors that may increase the risk of developing the disease are:
• smoking,
• excessive alcohol consumption,
• hyperlipidemia, i.e. abnormal values of LDL cholesterol and blood triglycerides,
• genetic predisposition.

Types of diabetic neuropathy
There are several types of diabetic neuropathy:
• latent neuropathy - can be detected by electrodiagnostic and quantitative sensory testing,
• generalized symptomatic neuropathy with features of symmetrical involvement of sensory and motor nerves innervating parts of the limbs and the autonomic system,
• focal bands.

Diabetic neuropathy treatment
Drug treatment of diabetic neuropathy does not bring long-term relief, primarily due to the lack of drugs that can act on the pathogenic mechanisms that cause it.
Aldose reductase inhibitors belong to a small group of compounds with this effect. However, the results of clinical trials proved disappointing. The current treatment is only symptomatic and is intended to bring relief from pain associated with neuropathy. To this end, patients are given painkillers, tricyclic antidepressants, anti-arrhythmics, and recently new antiepileptic drugs, gabapentins and lamotrigines, and opioid analgesics have also been used.

FREMS - relief for those suffering from diabetic neuropathy

Clinical studies have shown that FREMS has effects. This therapy, releasing VEGF, increases microvascular flow with an increase in TcpO2, improves pain control and accelerates the recovery of the peripheral nervous system.