diabetes and neuropathy - diffuse neuropathy

8/6/2019 Diabetes and Neuropathy - Diffuse Neuropathy

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Neuropathy is a nerve disorder w hich

can affect type 1 and type 2 diabetics

Diabetes and Neuropathy - Diffuse Neuropathy

Neuropathy (or diffuse neuropathy) is a a ne rve disorder of

which there are 2 types - peripheral and autonom ic. Diabetic

neuropathy is a nerve disorder caused by either type 1 or type

2 diabetes.

Types of neuropathy

There are 2 types of neuropathy - peripheral neuropathy,

which affects the feet and hands and autonomic neuropathy,

which affects the body's internal organs .

Over time, diabetics who do not strictly control their condition,

may develop damage to the nerves around the body.Incidences are more com mon in patients with poor control,

overweight, have higher levels of blood fat and blood pres sure, and a re over the age of 40.

The longer a person has diabetes, the greater the risk becomes of developing neuropathies.

Neuropathy may affect up to 50% of people with diabetes .[1]

Neuropathies are m anifested as a num bness or pain in the hands, feet, arms or legs. However, they

may also affect the organs , including the heart and sex organs. The scale of the comp lication is

imm ense, with an estimated half of all diabetics suffering from some form of neuropathy. The most

comm on type of neuropathy is peripheral (dis tal symmetric neuropathy).

What exactly causes diffuse neuropathy amongst people with diabetes?

The exact affect of glucose on the nervous system is still not known. However, prolonged exposure to

higher than normal g lucose levels certainly damages the nerves, causing neuropathy. A combina tion

of factors contributes:

Lifestyle: Depending on diet and exercise, smoking and alcoho l useMetabolic: High blood pressure, low insulin levels, abnormal blood fat concentration

Neurovascular: Damage of the blood vessels carrying oxygen and nutrients to the nerves

Autoimmune : Inflammation of the nerves

Inherited: Preconditions that increase vulnerability to nerve disease

What are the symptoms of diabetic neuropathy?

The symptoms of diabetic neuropathy will depend en tirely on the form of neuropathy present, and

which nerves are being affected. In som e

people, no symptoms will manifest

themselves.

Common symptoms of neuropathy

include:

Numbness

Tingling

Pain

These m ay be minor at first, and therefore

may remain unnoticed as the condition

develops graduall y. However, in some types

of diabetic neuropathy, the onset of the pain

will be s udden and severe.

Further symptoms include:

Wasting of muscles in feet or hands

Indigestion, nausea and vomiting,

Diarrhoea/constipation

Urinary problems

Impotence or vaginal dryness

Faintness or dizziness

Weakness of the limbs

What types of diabetic neuropathy could I be at risk from?

The different types of diabetic neu ropathy are detailed below:

Peripheral neuropathy

Peripheral neuropathy is ass ociated wit the peripheral regions of the body. These include the toes,

feet, lower and upper legs, the hands and the arms . Symptoms may include tingling, or insens itivity, a

burning sensation, pains and cram ps, and eventually a loss of balance. Peripheral neuropathy can

easily develop into ulcers, which when un treated can lead to amputation.

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Autonomic neuropathy

Autonomic neuropathy is less obvious, and affects the functioning of the bowel and the bladder, the

digestion, perspiration and sexual response. If left untreated, it can affect the awareness of the body to

hypoglycaemia. This can be incredib ly dangerous for diabetics . When the heart or circulatory system is

affected by autonomic neuropathy, the body’s ability to adjus t blood press ure and heart rate may be

affected.

How is neuropathy diagnosed?

Diagnos is will occur on the basis of your individual symptoms and a physical exam. The doctor may

test your blood pres sure, heart rate, strength, reflexes and s ens itivity. Foot examinations are

recommended for all diabetics.

Other tests such as nerve conduction studies , MG (electromyography) and QST (quantitative s ensory

testing) may also be applied. Doctors should screen for neuropathy amongst diabetic patients at leastonce per annum. Tests m ay include ultrasound, nerve studies and biops ies, or referral to a specialis t

neuropathy consultant who may conduct further tests.

How is diffuse neuropathy treated?

Diffuse neuropathy is treated by bringing blood glucose levels under control. This can he lp to prevent

problems from this diabetic complication. Diet, exercise or medication may be adjusted to reach these

goals. Exercise can be particularly effective, helping the patient to im prove circulation, strengthen

muscle and lose weight.

Smoking should be stopped and the amount of alcohol consumed should be reduced. Taking regular

care of your feet and skin is essential.

Nerve damage

Nerve damage in the digestive system can lead to constipation, and som etimes diabetic

gastroparesis. Also, the oesophagus m ay

become affected, making the swal lowing of

food difficult.

The urinary tract may also be affected, and at the worst stages this can caus e urinary incontinence.

Also, neuropathy can decrease s exual response in both men and women. The swea t glands may also

be affected, and the body may not be ab le to

control temperature properly.

Furthermore, the eyes can suffer problems

leaving them less sensitive to changes in

light.

Proximal neuropathy affects the h ips, bu ttocks

and thighs, and results in weakness of the

legs. This type of neuropathy occurs more regularly in type 2 d iabetics and in older people. It can

weaken the legs , sometimes to the extent of limiting mobility.

Focal neuropathy is man ifested in the rapid weakness of a nerve, or group of nerves, leaving the

mus cles weak and/or in pain . Focal neuropathy can affect any nerve in the body, but usually occurs in

the torso, leg or head. It can cause a variety of complications , including inability to focus, double vision,

aching behind the eye, paralysis , lower back pain, pain in various places throughout the body. It is both

unpredictable and painful, and usua lly affects the e lderly.

How do I preve nt diabetic neuropathy?

Maintaining cons istently normal blood glucose levels is the bes t way to prevent diabetic neuropathy.

Keeping levels stable protects the nerves.

How is diabetic neuropathytreated?

Bringing blood glucose levels within normal

range is es sential. Strictly managi ng diabetes

is the first stage in treating the condition.

Diet and exercise will almos t certainly play a

role in treating the condition.

Specific types of neuropathy (such as cranial

neuropathy, autonomic neuropathy,

compression mononeuropathy, femoralneuropathy, and thoracic neuropathy) and

their resultant complications may all be

treated in specific ways.

Why is footcare so important?

Peripheral neuropathy makes the foot incredibly vulnerable - hence foot care, and general skin care is

very important. One of the symptoms of neuropathy is a los s of feeling. Feet should be checked daily

for cuts, sores, blis ters, bruises and cracked or dry skin. If there is anything unusual - ge t to your doctor

as soon as possible.

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