The most common complication of diabetes is diabetic neuropathy. It is diagnosed in 30-50% of patients.
Disorders of the vegetative and somatic systems, impaired sensitivity and nerve conduction can speak about its presence.
What it is?
Under diabetic neuropathy in medicine is commonly understood to mean the totality of syndromes of violation of the divisions of the autonomic nervous and peripheral systems.
They arise as a result of disorders of metabolic processes in diabetes. There are several forms of diabetic neuropathy.
This diagnosis is one of the most severe and frequent complications of diabetes. It is characterized by symptoms of impaired sensitivity and conduction of nerve impulses, disorders of the somatic system, and much more.
Classification and forms
Neuropathy is peripheral and autonomous.Neuropathy is classified by the following points:
- damage mechanism: axonal, neuropathic, demyelinating;
- by type of nerve fiber: sensory-motor, autonomic, sensory, mixed, motor;
- depending on the area of nerve damage: sensory (tissue sensitivity is disturbed), sensory (mixed lesion), motor (motor function and muscle function is disturbed).
The main factor in the onset of diabetic neuropathy are stably elevated blood glucose levels, which ultimately lead to changes in the functioning and structure of nerve cells.
In addition, the causes of neuropathy can be:
- age over 60 years;
- high blood pressure;
- obesity or overweight;
- long course of diabetes;
- the presence of bad habits;
- decompensation phase.
The most important in the pathogenesis of neuropathy are metabolic disorders and microangiopathy (structural or functional changes of the capillaries, which are responsible for microcirculation in the nerve fibers).
Exchange changes include such processes:
- a decrease in the level of myo-inositol, accompanied by a depletion of phospho-inositol synthesis, which results in impaired nerve impulses and a drop in energy metabolism;
- increased oxidative stress;
- activation of the polyol shunt (impaired fructose metabolism);
- enzymatic and non-enzymatic glycosylation of the structural components of the nerve fiber - tubulin and myelin;
- production of autoimmune complexes.
The main symptoms of diabetic neuropathy are:
- negative neuropathic symptoms;
- significant reduction or absence of knee and Achilles reflexes;
- excessive disturbance of sensitivity;
- impaired walking.
Diagnosis and treatment
First of all, for the diagnosis of neuropathy, the specialist checks the patient's sensitivity. An injection is given to the definition of pain.
Tactile sensations are also checked by touch, pressure monofilament, warmth and cold. Vibration sensations are determined by means of a tuning fork.
No cost and without checking the knee jerk. The patient can conduct all these actions independently, which will help him to determine whether he has diabetic neuropathy. A doctor using specialized equipment will determine the type, stage and severity of the diagnosis.
For treatment using a comprehensive method of therapy, which includes:
- alpha lipoic acid. It prevents the accumulation of glucose in the nerve tissues, and also activates some enzymes in cells that are able to restore the affected nerves;
- vitamins of group B. They block the toxic effect that glucose has on the nerves;
- Actovegin. Utilizes glucose, stabilizes blood microcirculation;
- aldose reductase inhibitors. Lowers the negative effects of glucose on the body;
- agents based on calcium and potassium. Reduce numbness and cramps.
One of the common complications of diabetes is neuropathy of the lower extremities, accompanied by the formation of diabetic foot. It develops mainly after 5-7 years from the onset of the disease in the first type of diabetes. At the second, this diagnosis appears much less frequently.
The underlying factor in the development of diabetes complications is a low level of glucose compensation. Such a symptom is observed due to a severe form of the disease, or non-compliance with the recommendations of the endocrinologist. High blood sugar and sudden drops negatively affect the nerve fibers and vascular wall.
Diabetic foot syndromes are as follows:
- immunity drop;
- angiopathies (vascular disorders);
- infection of ulcers;
- osteoporosis and bone damage.
The diabetic foot can occur in ischemic and neuropathic form, depending on the disorders that prevail. However, often both factors are involved simultaneously.
Due to sensorimotor neuropathy, the ability to move is reduced, and strange sensations may occur due to nerve damage.
The main reason for the diagnosis is the disease, or nerve damage. This process can occur outside the spinal cord and is called peripheral neuropathy.
This disease is a pathology, as a result, it can affect the important nerves, whose function is to provide feelings or causes of movement. Thus, sensorimotor neuropathy may develop. Its main purpose is to influence movement.
Due to numerous cell damage, the process of slowing down nerve signals occurs. And due to the impact of neuropathy on the nerve fibers or whole cells may be a loss of their performance.
A frequent symptom is a decrease in sensitivity in one of the areas of the body, and pathology is often accompanied by:
- difficulty swallowing;
- the difficulty of using hands;
- burning sensation;
- weakness in various parts of the body;
- pain and difficulty walking;
- abnormal sensations in any part of the body.
Symptoms of sensorimotor neuropathy can develop at different rates, both quickly and slowly, over many weeks or years. Most often, this pathology begins to manifest at the ends of the fingers.
Autonomous diabetic neuropathy is a pathology that specifically affects the vegetative part of the nervous system, its main function is to control and coordinate the work of the internal organs. Also during its occurrence, the manifestation of various disorders on the part of many organs is characteristic.
Symptoms that appear with this diagnosis, manifested in the form of:
- sudden nausea;
- when eating even a small amount of food, there is a heaviness in the stomach;
- slowing the transport of food from the stomach to the intestines.
These symptoms indicate abnormal functioning of the stomach.
Also during this, the nerves that are responsible for the state of the small intestine may be impaired, which then goes into the development of nocturnal diarrhea.
With autonomic neuropathy, the nerves responsible for erection during sexual arousal in men are adversely affected. This often leads to erectile dysfunction, which does not remove sexual desire and desire in the patient. As for the female, patients may complain of severe dryness in the vagina, as well as the absence or reduction of sexual desire.
Prevention and treatment of diabetes neuropathy:
Diabetic neuropathy is one of the most common complications in diabetics, it is diagnosed in almost half of all patients. It comes in different classifications and forms, each of which has its own characteristics of course and symptoms. Most often this diagnosis occurs in patients with the first type of diabetes.