Diabetic neuropathy

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Diabetic neuropathy is a complication of diabetes that occurs as a result of damage to nerves. This nerve damage is usually in the legs and feet. Symptoms of diabetic neuropathy can range  from mild to disabling. There is no cure for diabetic neuropathy but treatment are available to help manage symptoms.

TYPES AND SYMPTOMS

There are different types of neuropathy depending on which nerve is affected.

Peripheral neuropathy : This is the most common form of diabetic neuropathy. Symptoms usually include pain, numbness, tingling and burning of lower legs and feet. Other symptoms include pain while walking, muscle weakness and difficulty walking, foot problems such as  ulcers, infections, deformities,  bone and joint pain.

Autonomic neuropathy : It affects nerves of  the autonomic nervous system. The autonomic nervous system comprises of the heart, bladder, lungs ,intestines, stomach, eyes and sex organs. Symptoms include sexual dysfunction, incontinence, diarrhea, increased or decreased sweating, inability to control blood pressure, increased heart rate when at rest and constipation.

Radiculoplexus neuropathy (diabetic amyotrophy) : It is also called diabetic amyotrophy, femoral neuropathy  or proximal neuropathy and usually affects people with type 2 diabetes.  It affects nerves in the thighs, hips, buttocks and legs. Symptoms include pain in usually one side of the buttocks, hips or thigh pain and weakness in the legs,abdominal swelling, difficulty  rising from a sitting position and weight loss.

Mononeuropathy : This involves damage to a specific nerve and usually occurs suddenly. It is also known as called focal neuropathy. Symptoms include chest pain, vision change , eye pain, pain in localized area of the body and Bell’s palsy.

CAUSES

Uncontrolled high blood sugar can damage nerves. It weakens the ability of nerves to conduct signals and weakens the walls of capillaries that supply nerves with nutrients and oxygen. Other factors such as nerve inflammation, smoking, alcohol abuse and genetic factors may increase your risk.

RISK FACTORS

Diabetics can develop this condition, but certain factors increase your risk of getting it.

  • uncontrolled blood sugar
  • smoking
  • kidney disease
  • having diabetes for a long time

TEST AND DIAGNOSIS

To diagnose diabetic neuropathy, doctors usually check  symptoms, medical history and do a physical exam. Doctors may however do these tests  to confirm their diagnosis.

Electromyography (EMG) : It measures the electrical discharges produced in your muscles.

Filament test :  It is done to test your sensitivity to touch.

Nerve conduction studies : It studies  the flow of electrical current through the nerves.

TREATMENT

Treatment does not cure diabetic neuropathy , however it helps one manage symptoms and control blood sugar so that neuropathy does not get worse.

Treatment include relieving nerve pain using these medications.

Anti-seizure medications such as gabapentin (Neurontin), carbamazepine (Tegretol), and  pregabalin (Lyrica).

Antidepressants such as  tricyclic antidepressant drugs,  including nortriptyline (Pamelor, Aventyl) and  desipramine (Norpramin). You can also use  duloxetine (Cymbalta).

Opioids analgesics such as  tramadol (Conzip, Ultram, others) or oxycodone (Oxecta, OxyContin) may also be used in more severe cases.

Other treatments include patches containing the topical  anesthetic agent lidocaine and capsaicin cream.

For autonomic neuropathy, antispasmodic or anticholinergic drugs can help prevent  urinary incontinence.  Vaginal estrogen creams and lubricants  may provide relief for  vaginal dryness and irritation and  sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) for erectile dysfunction.

PREVENTION

Take these precautions to prevent diabetic neuropathy.

Control your blood sugar.

Proper foot care such as keeping feet clean and dry, trimming nails careful and checking feet everyday for cuts, swelling, redness and bruises can also help

 

 

 

 

 

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