Numbness, pain and abnormal sensation in the extremities are symptoms of diabetic peripheral neuropathy, the most common complication of diabetes mellitus. To date, 210 surgeons have trained and performed procedures with Professor Dellon throughout the United States and 13 countries worldwide. Approximately 40,000 patients have undergone the procedure and to date, no patient has had a lower extremity ulcer or amputation. Why do patients with diabetic peripheral neuropathy have peripheral nerve compression? The peripheral nerve starts in the spinal cord and innervates the fingers and toes. In this pathway, there are multiple anatomical stenoses. These physical stenoses are present in everyone. For example, the ulnar nerve canal and carpal tunnel and similar stenoses exist in the lower extremities next to the knee and within the ankle. Many people are born with these physiologic stenoses so the nerve is more likely to be compressed within them. For example, a small carpal tunnel or a canal with an extra muscle running through it. The following two factors may explain why peripheral nerves are susceptible to compression in people with diabetes. One, the peripheral nerve is swollen in diabetic patients. Normally blood sugar enters the nerve to provide energy and convert it to fructose, and high blood sugar causes fructose to build up in the peripheral nerves of diabetics. The molecular formula of fructose determines that it binds water easily. Therefore, water is drawn into the nerve and causes swelling of the nerve. This phenomenon was confirmed in 1978. So it is conceivable that if a nerve swells at an anatomical stenosis, then the nerve will be compressed and produce symptoms. Second, the transmission system within the nerve is dysregulated in diabetic patients. Nerves are filled with a variety of substances that allow important chemical messages to pass within the nerve. It is the transmission of information that allows the central nerve to understand what is going on at the distal end. If a nerve is damaged such as by compression, its cell membrane needs to be rebuilt and these repair proteins need to be passed downstream along the microtubular proteins within the nerve. This dysfunction of cis-axis plasma transport in the nerves of diabetic patients was reported as early as 1979. This means that damaged nerves in diabetic patients have difficulty repairing themselves in vivo, so that nerve repair and consequent symptoms are difficult after peripheral nerve compression. The surgery often performed on patients with nerve compression (such as those with carpal tunnel syndrome) can also be used in diabetic patients to restore their sensation and muscle strength. Carpal tunnel decompression is one of the most common procedures performed in the United States, and probably someone you know has undergone this procedure. This procedure can be performed on the arms, hands, legs and feet by cutting through ligaments or fibrous tissue to release the compressed areas of the nerve pathway. This reduces the compression on the nerve, improves the blood supply to the nerve, and allows the nerve to glide with the movement of the adjacent joint. If the patient has other diabetic complications, such as optic neuropathy or even blindness, it is especially important to re-establish sensation in the fingertips, not only in relation to daily life, but also in relation to Braille reading. We perform triple incision treatment for diabetic lower extremity neuropathy with good results, and this procedure is a very meaningful treatment option.