Hyperglycemia leads to microvascular injuries and vasoconstriction as well as unwanted glycosylation of proteins. The resulting neural damage is worsening over the course of time, starting inconspicuously with an odd feeling in the lower extremities. Dr Grisold describes it as “a feeling like wearing socks”. Already at this stage caution should be exercised, because the numbness can increase the risk for tripping and falling. Moreover, bruises due to inadequate footwear are no longer noticed. As polyneuropathies progress they can lead to chronic pain and may also affect inner organs and eyesight.

Regulation of blood sugar levels can prevent the progression of the disease. Current therapies are limited to symptomatic treatment and pain management. However, the regeneration of damaged nerves is a major focus of research.