Why Develops Diabetic Neuropathy
Author: Calvert LambertDiabetic neuropathy is a combination of syndromes of nervous system.The main cause of diabetic neuropathy is hyperglycemia. The spread of diabetic neuropathy in both types of diabetes is about 30%. While diabetes of the 1st type after 5 years from the beginning of the disease it started to be noticed of 10% of the patients. The frequency of diabetic neuropathy in 2nd type of diabetes is about 6% of the patients per year. The most common variant is the distal symmetric sensorimotor diabetic neuropathy.
Sensorimotor diabetic neuropathy is expressed by complex of motor and sensory disorders. The most common symptom of this disease is paresthesias, which shows a sense of “crawling” numbness. Patients often complain on weakness of legs, although they are still warm to touch, actually it is a sign that distinguishes polyneuropathy from ishemic changes when the feet are cold to touch.While this kind of neuropathy can be seen dystrophy and degenerative infringements of skin, bones and joints. Lack of sensitivity leads to small microtraumas of a patient, moreover develops swelling, chronic purulent processes and locomotor system.
There are several types of autonomous diabetic neuropathy.The cause of cardiovascular type – is an infringement of the innervation of the heart-lung complex and large vessels. The vagus nerve is the longest nerve, according to this it is affected earlier than the others. As a result of the predominance of sympathetic influences develops tachycardia. Inadequate response to orthostasis is expressed by orthostatic hypotension and syncope.
Among the symptoms of gastrointestinal type of diabetic neuropathy is gastroparesis with delayed or conversely rapid gastric emptying, which may create difficulties in the selection of insulin therapy, because the time and absorption of carbohydrates vary indefinitely.For urogenital form of diabetic neuropathy is typical atony of the bladder and ureters, leading to urinary tract infections, erectile dysfunction, retrograde ejaculation.
Among the other diabetic neuropathy symptoms – infringement of the ability to recognize hypoglycemia, impaired function of the apple of the eye, infringement of the sweat glands, diabetic amyotrophy, numbness, decrease of muscles, infringement while indigestion, vomiting, diarrhea, dizziness and faint while fall of blood pressure or change either horizontal or vertical position.
Examination of patients with diabetes should be conducted annually. At least it means carrying out tests aimed at searching for distal sensorimotor neuropathy. Treatment while any signs of diabetic neuropathy should include foot care, optimization of the glucose-lowering therapy, usage of neurotropic drugs, symptomatic treatment, such as pain relief, sildenafil for erectile dysfunction, orthostatic hypotension in fludrokortizon.
In the initial stages diabetic neuropathy can be treated on the background of stable compensation of diabetes. Diabetic neuropathy is defined at 80% of patients with ulcerative lesions and is a major risk factor for amputation of the feetwhile diabetes.
-----------------------------------------