why some diabetic patient cannot sense towards stimuli?

sometimes, you can notice that diabetic patient cannot sense well when they are step on a nail or hard thing.they have to wear slipper although there are at home.to prevent any innjury..this condition is known as diabetic neuropathy generally or peripheral neuropathy specifically.

WHAT IS DIABETIC NEUROPATHY
Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

WHAT CAUSES DIABETIC NEUROPATHY

Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors:

• metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin
• neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves
• autoimmune factors that cause inflammation in nerves
• mechanical injury to nerves, such as carpal tunnel syndrome
• inherited traits that increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use

WHAT ARE THE SYMPTOMS OF DIABETIC NEUROPATHY

Symptoms of nerve damage may include

• numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
• wasting of the muscles of the feet or hands
• indigestion, nausea, or vomiting
• diarrhea or constipation
• dizziness or faintness due to a drop in blood pressure after standing or sitting up
• problems with urination
• erectile dysfunction in men or vaginal dryness in women
• weakness

TYPES OF DIABETIC NEUROPATHY

Peripheral neuropathy affects

• toes
• feet
• legs
• hands
• arms

Autonomic neuropathy affects

• heart and blood vessels
• digestive system
• urinary tract
• sex organs
• sweat glands
• eyes
• lungs

Proximal neuropathy affects

• thighs
• hips
• buttocks
• legs

Focal neuropathy affects

• eyes
• facial muscles
• ears
• pelvis and lower back
• chest
• abdomen
• thighs
• legs
• feet