Diabetic neuropathy

January 2017


Definition


Diabetic neuropathy is a complication of diabetes. This is a very common disease among people with diabetes that lasts for many years and is often due to diabetes being poorly controlled. It is caused by the detrimental effects of chronic hyperglycemia resulting in the destruction of the myelin that surrounds nerves and has a major role in the conduction of nerve impulses. In fact, too much sugar in the blood eventually alters or prevents nerve conduction. Neuropathy can affect one (mononeuropathy) or multiple nerves (polyneuropathy), mainly those of the lower limbs. It can also affect digestive or genito-urinary organs. Lastly, diabetic neuropathy has a major role in the occurrence of another complication of diabetes, the diabetic foot.

Symptoms


Diabetic neuropathy occurs differently from one case to another, depending on whether the autonomic, sensory or motor nervous system is affected. Symptoms therefore depend on the affected area and are therefore highly variable:
  • In most cases, including polyneuropathy, impaired sensitivity with reduced sensation at the end of these nerves, at the end of the foot for example. Burning sensations may also occur;
  • sometimes in mononeuropathies, it may affect the femoral nerve with pain and loss of feeling in the affected leg;
  • digestive problems with sensation of acid reflux, bloating or diarrhea;
  • disorders of adaptation of the cardiovascular system with hypotension when rising to a standing position;
  • erectile dysfunction in men;
  • diabetic foot wound often due to loss of sensation of pain.

Diagnosis


Symptoms of diabetic neuropathy are different from one person to another. It should be looked out for, when changing for someone with longstanding diabetes. A neurological examination is also complemented by a test of the sensitivity of the lower limbs, since polyneuropathies are the most common of these complications. With his eyes closed, the patient has to say if he feels or not various cutaneous stimulation performed with a small string: this is called a monofilament test.

Treatment


The treatment of diabetic neuropathy involves obtaining optimal glycemic balances. Generally, it helps to stabilize the progression of the disease and to prevent it from worsening. Treatment of pain is adapted to each case, with molecules acting on pain of nervous origin. A follow-up by a physiotherapist provides rehabilitation.

Prevention


Prevention of diabetic neuropathy is similar to the prevention of diabetes. In a person who is already diagnosed with diabetes, prevention is based on respecting lifestyle and dietary rules that he has been taught: a good control of his diabetes, and a regular look-out for the onset of complications.

Related

Published by Jeff. Latest update on July 1, 2013 at 01:33 PM by Jeff.
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