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How can type 2 diabetes cause nerve disease?

How type 2 diabetes causes nerve injury is not completely understood.  Type 2 diabetes results in a series of metabolic changes including high levels of blood sugar and fats (i.e. hyperglycemia and hyperlipidemia) which can disrupt the blood supply to the nerves causing nerve injury.  The immune system may further contribute to nerve injury.  These are the mechanism which are thought to contribute to a common nerve disease termed diabetic polyneuropathy in which patients complain of numbness, tingling and prickly or buring feelings in the feet.  Diabetics are also prone to pressure related nerve injury such as carpal tunnel syndrome a condition in which patients complain of numbness and tingling in the hands.  Risk factors for nerve injury include age, duration of type 2 diabetes, and poorly controlled type 2 diabetes.   

Due to the disruption of the microcirculation, the nerves can become damaged in diabetes, creating a condition called neuropathy. Typically, patients feel numbness, tingling, or a prickly pins-and-needles sensation in their legs. The numbness in the legs of diabetic patients can be a hazard for injuries. A person with diabetes can injure him or herself and not feel anything. Because the oxygen supply to the area is also compromised in diabetes, healing can be very slow and infection can occur more easily. These can become so severe that they result in the loss of a limb. This is the reason that amputations occur in diabetes at a much higher rate than in other patients. 

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