One of the commonest complications of diabetes is the nerve problem – Diabetic neuropathy.The presence of cardiovascular problems, raised triglyceride, and hypertension pose a greater propensity for the involvement of nerves.
Symptoms:
Based on the type of nerves involved in your body, you find the distribution of symptoms and the type of sensations..
1. You may have numbness, tingling, sharpness or burning sensations starting at your soles (feet) and also at your palms and hands in both limbs symmetrically and slowly extending above which is the most common.
2. You may sometimes find disturbances in your daily life like nocturnal diarrhea, impotence, difficulty voiding, sweating problems, abnormal fullness after having food, on standing you might find to be hypertensive.
3. You might feel burning or a stabbing sensation in the truncal region, which are usually of sudden onset. and some times severe buttock pain, or pain in the anterior part of thigh and back acutely.
4. With the symptoms already mentioned previously, their might also be a vision problem (perception of things in two images called diplopia ), pain at the back of eye.
5. And also with time, you might perceive symptoms due to compression of a particular nerve; like pain at the wrist, tingling sensation in hands, foot , also in legs which involve only one part of the body.
Why are the nerves involved in diabetes?
The affects of more glucose and its consequences in the body is the culprit, this is responsible for all the complications,
So the utmost importance is to maintain your glucose levels …..
What happens if the nerves are damaged?
The nerves, which have suffered damage fail to carry the sensations they ought to, and so you do not feel the sensations. And this becomes a problem in case of your feet, which are usually prone to injury.
So when an injury occurs, you do not feel it and it becomes an ulcer, and the ulcer fails to heal and is also prone to infections and this continues to become worse if unnoticed.
The gravity of the problem can be understood if one point is kept in mind..
If you do not check your foot periodically you will be at risk of amputation..
He does clinical tests on your body, to find out the nature of sensations and reflexes you might have lost due to nerve damage, using cotton, pointed instruments, knee hammer, and localizes the nerve involved..
Tests suggested:
1. Blood for sugar levels, glucose tolerance test.
2. Blood pressure.
3. EDx studies
4. Nerve biopsy.
5. Lumbar Puncture rarely for CSF examination.
6. MRI.
Treatment:
1. Glycemic control is very important tool in halting the progress of the disease.
2. Control of hypertension, hyperlipidemia.
3. Quitting alcohol and smoking.
4. Supplementation with possible vitamin deficiencies like B 12 .
5. Periodic checkup of foot, taking precautions aimed at preventing ulcerations, and if deformities are present meet a podiatrist.
6. For painful conditions, antidepressants like amitriptyline and others, Anti convulsants like Duloxetin, and Pregabalin are given.
7. Other drugs : Aldosterone reductase inhibitors like sorbinol , tolrestat, antioxidants like lipoic acid.
8. Decompression surgeries for the nerves compressed.
Remember, as once neuropathy has established, few affective treatments exist…so it the control of your sugar levels, which play the key role…….
by on 24. Jan, 2010 in Diabetes Complications
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