The foot often becomes wider and shorter, the gait changes, and foot ulcers appear as pressure is put on parts of the foot that are less protected. Because of the loss of sensation, injuries may go unnoticed and often become infected. If ulcers or foot injuries are not treated in time, the infection may spread into the bone and because this is almost impossible to treat, the foot, or lower leg, may require amputation. However, problems caused by minor injuries can usually be controlled if they are caught in time. Avoiding foot injury by wearing well-fitted shoes and examining the feet daily can help prevent amputations.
Autonomic neuropathy is another form of diffuse neuropathy.
It affects the nerves that serve the heart and internal organs and produces changes in many processes and systems. The autonomic nervous system controls unconscious body functions, for example, digestion. Autonomic neuropathy eventually affects about 30 percent of diabetics, usually by slowing these functions down. The best way to prevent neuropathy is to practice tight blood glucose control. Compared with the conventional group, those who practised tight control reduced their risk of developing neuropathy by 69 percent.