In diabetes mellitus, patients can suffer from serious nervous debility and neuropathic affection of the hand will occur due to involvement of peripheral nervous system. It occurs in 30% patients suffering from diabetes.
Initially, diabetic neuropathy of hand is symptomless and later the symptoms begin to appear gradually. The sense of perception of vibration is lost in the diabetic neuropathy. Along with it paraesthesia is present that is, the person feels the pricking of needles and pins. There is dull, aching pain which is aggravated at night. The hands become numb; muscles become weak and wasting of the muscles begin to occur. Patient is not able to feel the cold and hot in the hands and this can cause severe thermal injuries. Such patients will not icy coldness of the cold things and the boiling heat of hot drinks. There is loss of strength and the power to pick up light weight objects will be lost. Patient suffers loss of reflexes.
Generally, the diabetic patients feel chill as a result of dilated blood vessels. This is accompanied by the edema of the region. The skin of hands become dry and develops cracks. The sweat glands become nonfunctioning, the condition is known as anhydrosis as a result there is no perspiration. Finally, ulcers will develop.The disease becomes advanced with the passing years of life diabetic neuropathy leads to the reduced perception of pain, warm hand, dry skin with cracks and fissures, no sweat, reduced pulse, reduced mobility of joints, ulcers, infection and finally gangrene results in due to absent nerve functioning. The hand needs to be amputated if the gangrene has set in else the infection will spread to other regions and sepsis occur leading to death of the patient. The injury occurs very easily due to diabetic neuropathy. It can be prevented by controlling the high levels of glucose in the early stages of diabetes.