A. Why diabetic patients will have numbness in their hands and feet Diabetic patients often experience numbness and pain in their hands and feet after the onset of the disease for a period of time, and even burn because they do not feel the temperature change when washing their feet, or worse, do not even know that a nail has been stuck in the bottom of their feet, and finally form a stubborn ulcer and amputate their limbs. In fact, this is due to a common complication of diabetes called diabetic neuropathy. Diabetic Peripheral Neuropathies (DPN): refers to the symptoms and/or signs associated with peripheral nerve dysfunction in diabetic patients when other causes are excluded. syndrome. Common symptoms include numbness, pain, and weakness of the limbs in the hands, feet, and lower legs. The disease is mostly progressive and insidious in its course. Diabetic peripheral neuropathy is a common and distressing complication in diabetic patients, with a high rate of disability and mortality. In developed countries, diabetes is the most common cause of peripheral neuropathy. Diabetic neuropathy has a higher rate of hospitalization compared to other diabetic complications, accounting for 50-70% of non-traumatic amputations. Second, how diabetic peripheral neuropathy develops once the disease and its hazards How diabetic peripheral neuropathy develops The development process of diabetic peripheral neuropathy is often manifested in two categories: one is the gradual progressive development of symptoms, gradually worsening and irreversible course; the second is relatively sudden onset and can be completely remitted. The progression of distal symmetric neuropathy (DSPN) is associated with glycemic control in type 1 and type 2 diabetes. Neurological deterioration is seen within 2-3 years of the onset of most type 1 diabetes; slowed nerve conduction velocity in type 2 diabetes is one of the earliest neurological abnormalities and can be present at the time of diagnosis. Nerve conduction velocity slowing after diagnosis usually decreases at a fixed rate of 1 m/s per year, and the degree of impairment is positively correlated with the duration of diabetes. In studies with long-term follow-up of type 2 diabetes, the prevalence of electrophysiological abnormalities in the lower extremities increased from an initial 8% to 42% after 10 years, mainly due to axonal destruction and small neuropathy. The main risks of diabetic peripheral neuropathy (DPN) are 1) numbness and pain in the hands and feet/or extremities, especially at night, when the pain is so severe that the patient cannot touch the sheets or other objects and may wake up in pain several times; 2) weakness in the limbs and unstable walking, especially at night; 3) the risk of forming stubborn ulcers in the feet and even amputation as a result. The risk of amputation in patients with DPN is 1.7 times higher, and the risk is 12 times higher if there is a foot deformity, and 36 times higher if there is a previous history of foot ulcers. Fifty to 75 percent of non-traumatic amputations are in patients with DPN. Approximately 85,000 amputations occur each year in the United States due to this disease, with an average of 1 amputation every 2 minutes, and neuropathy is a major cause in 87% of patients. The severity of diabetic peripheral neuropathy in China: At present, there are nearly 90 million diabetic patients in China. An analysis of 24,496 cases of DM patients by the Chinese Medical Association’s Division of Diabetes from January 1991 to December 2000 found that diabetic neuropathy accounted for 60.3%, with the incidence of type I diabetes at 44.9% and type II diabetes at 61.8%. The onset of clinically significant diabetic peripheral neuropathy was often evident within 10 years of diabetes diagnosis, and its prevalence was correlated with the duration of the disease; neurological function tests revealed varying degrees of neuropathy in 60-90% of patients, with 30%-40% of patients asymptomatic. The main risk factors for diabetic peripheral neuropathy are: 1. smoking 2. age over 40 years; 3. poor glycemic control.