Diabetic neuropathy is the most common complication of diabetes. Diabetic neuropathy is damage to the nervous system caused by diabetes. Too much sugar in the blood destroys the endings of nerve fibers, and the consequences can be dire. What are the types and symptoms of diabetic neuropathy? What is treatment and rehabilitation?

Diabetic neuropathydenotes damage to the peripheral nervous system that is caused by diabetes.Diabetic neuropathyis present in both type 1 diabetes (requiring insulin) and type 2 diabetes (which can be controlled by lifestyle).

Diabetic neuropathy - causes

In type 2 diabetes, neuropathy develops gradually. The persistent excess of sugar systematically weakens the rate of conduction of various stimuli through the nervous system.

In type 1 diabetes, it happens very quickly, often immediately after the onset of the disease, and after 2-3 years it stops or continues to develop very slowly.

Diabetic neuropathy - types

1. Sensory neuropathy

Sensory neuropathy, or polyneuropathy, weakens the peripheral nerves, which are the nerves found in the skin and muscles.

2. Autonomic neuropathy

Autonomous neuropathy destroys nerves that act independently of our will. This is a rare, but very dangerous form of the disease, as it can paralyze almost every system in the body.

Most often, however, it attacks the nerves that regulate blood pressure, sweating, bladder and bowel function. It can also cause poor digestion, diarrhea and even fainting.

3. Focal Neuropathy

Focal neuropathy attacks nerves in a limited (one or more) part of the body. The disease develops when the vessels that feed one or a group of nerves lose their patency. This often results in a blood clot forming.

Then there is a sudden and severe pain that only passes after a long time, when the adjacent nerve takes over the functions of the damaged one.

Diabetic neuropathy - symptoms

Sensory neuropathy

Patients experience severe tingling in their feet (so-called sock tingling) or in their hands (glove tingling).

There are long-lasting muscle pains in the legs and cancer, sometimes they are severe, butshort duration. If the motor muscles are also damaged, they disappear. For the same reason, foot deformities occur.

  • Muscle and joint pain (musculoskeletal) - causes

The most dangerous are pain disorders, because the patient often does not know that he has cut, stung or rubbed the skin. And because diabetes makes it difficult to heal wounds, it is easy for a wound to become infected or the formation of painful calluses on the soles of the feet.

Anatomical neuropathy

If the nerves that control the digestive tract are damaged, you have digestive problems. When the disease attacks the esophagus, it manifests as swallowing disorders, the feeling of every bite stopping in the throat.

If the innervation of the stomach is dominant - present

  • nausea
  • vomiting after meals
  • feeling full too quickly
  • even anorexia

Nerve damage can also affect the work of the gallbladder. Then the patient suffers from bloating after meals, pains over the navel and stomach pains on the right side, under the ribs, which sometimes resemble acute bouts of biliary colic.

The most troublesome symptom of gastrointestinal autonomic neuropathy is nocturnal diabetic diarrhea. When the disease develops, the patient has to get up to the bathroom several times a night.

This form of diarrhea does not cause pain, but makes it very difficult to treat diabetes. It is conducive to the occurrence of hypoglycaemia and malnutrition. In some people, neuropathy may present as constipation that alternates with diarrhea.

Focal neuropathy

When glucose damages nerves in many places, you may experience double vision, foot drop, shoulder pain, and back pain.

According to an expertdr Alicja Ciesielska, diabetologist, Diabetes Outpatient Clinic at the Grochowski Hospital in Warsaw

Diabetic neuropathy - diet and more

Regardless of the type of neuropathy, the progression of the disease is influenced by the duration of diabetes and whether it is properly controlled. If properly and successfully treated and episodes of hyperglycemia, or excessive blood glucose levels, are rare, neuropathy progresses very slowly.

For the treatment to work, you need to normalize your blood sugar level. You may also need medications to support the circulatory and nervous systems, reduce blood viscosity, and speed up wound healing and scarring.

The diet is also important, in this case it should be treated as a medicine. 50-60 percent calories should come from the complex (slowly absorbing) carbohydrates you findin coarse-grained groats, cereals, dark bread, uncleaned rice, potatoes, pasta, 30-35% from fats, and the least, because only 10-15%, from proteins. It is also worth remembering that smoking and drinking alcohol contribute to nerve tissue damage.

Worth knowing

Neuropathy starts innocently

It starts with tingling feet and hands, reducing sensitivity to temperature, light touch or a gentle sting.

A little later there is numbness and an alternating sensation of cold or hot. The skin burns or itches intensely. The patient feels as if they are walking on rough ground, e.g. stubble or sheep's wool.

The skin becomes extremely sensitive to every touch, even of a light duvet or sheet. The ailments worsen on cold days.

There are several types of neuropathy depending on which parts of the nervous system are damaged.

Diabetic neuropathy - treatment and rehabilitation

Sensory neuropathy

The mainstay of treatment of sensory neuropathy is the regulation of blood glucose levels. Intensive insulin therapy in patients with type 1 diabetes has a huge impact on preventing damage to peripheral nerves.

In type 2 diabetes, similar effects can be achieved by systematically controlling blood sugar levels.

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Anatomical neuropathy

Modern medicine has little to offer for those suffering from the digestive form of neuropathy. Medications to slow down bowel movements are recommended and you should eat frequently but small amounts of well-comminuted foods.

Damage to the nerves that control the bladder means that the patient does not feel the pressure, so he does not know when his bladder is full. And there is no effective solution for that. It's best to go to the toilet regularly, every 2 hours.

Another complication is impotence. Almost half of men with diabetes suffer from problems getting and keeping an erection.

This is usually due to damage to the blood vessels that regulate blood flow to the penis. Women with diabetic neuropathy may also have sexual problems.

Focal neuropathy

If the neuropathy is only painful, pain relievers and sometimes anti-depressants are effective. Sometimes physical therapy or surgery can bring you a lot of relief and feel better.

Problem

Diabetic foot

Diabetic foot is a complication of diabetes. This is a problem of as much as 70 percent. patients whose disease has damaged the peripheral nervous or circulatory systems. With the so-calledof a neuropathic diabetic foot, the patient does not feel pain, touch or even a prickle.

As the disease progresses, the affected leg develops tingling, burning or an unbearable burning of the skin. Impairment of the sweat glands makes the skin on the feet very dry, which promotes cracking.

Insufficient blood supply to the feet also affects the condition of the bones, especially the joints in which articular cartilage disappears. When diabetes damages the arteries in the legs, they gradually overgrow with plaque, making the veins less flexible.

The fact that the disease is progressing is evidenced by painful night cramps, tingling and prickling. The appearance of the skin also changes - it becomes dry, flaky, and in men, the hair on the calves disappears. You can notice numerous small cracks on the heels, corns on the toes, and calluses on the soles.

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