Understanding Diabetic Neuropathy
Diabetic neuropathy is a type of nerve damage that occurs due to diabetes. High blood sugar levels in the long term can cause damage to nerve fibers throughout the body, such as the legs, feet, blood circulation, heart, digestive system, and urinary tract. Diabetic neuropathy includes serious complications of diabetes.
Diabetic neuropathy can not be cured, but drug administration can overcome the symptoms that arise.
Keep your sugar levels and live a healthy lifestyle to avoid this disease. While in diabetic neuropathy patients, maintaining blood sugar levels and living a healthy lifestyle can slow the progression of the disease.
Symptoms of Diabetes Neuropathy
Symptoms of diabetic neuropathy generally develop gradually and the new patient noticed after significant nerve damage. Based on the location of damaged nerves, diabetic neuropathy is divided into four types, namely mononeuropathy, autonomic neuropathy, femoral neuropathy, and peripheral neuropathy.
Mononeuropathy or focal neuropathy regarding certain nerves on the face, torso, or legs. Although the symptoms can be painful, the condition may improve by itself within a few weeks or months. Symptoms arising from mononeuropathy include:
- Paralyzed on one side of the face.
- Pain in the shinbone, leg, pelvis, lower back, quadriceps, chest, or abdomen.
- Pain behind the eyes, difficult eyes focus, or double vision.
- In the digestive system: bloating, diarrhea, constipation, vomiting, or heartburn.
- In the vascular system: the heartbeats become faster, lower blood pressure, dizziness, nausea, vomiting, or dark vision after standing quickly (orthostatic hypotension).
- In the genital system: erectile dysfunction, dry vagina, or difficult orgasm
- In the urinary tract: bloating, urinary incontinence, or difficulty emptying the bladder (when urinating is not complete).
- It's hard to get up from a sitting position.
- The stomach becomes swollen.
- Severe pain in the waist, thighs, or buttocks.
- Tingling in the lower legs, or feeling hot.
- Cramps or pain.
- Reflexes are reduced.
- Loss of balance and coordination.
- Muscles are weak.
- Serious foot problems, such as infection, ulcers, joint and bone pain, or deformity.
- Numbness or decreased ability to feel pain and changes in temperature.
Causes of Diabetes Neuropathy
Diabetic neuropathy is caused by a combination of several factors. The main factor is high blood sugar levels in a long time that makes the blood vessel wall (capillary) becomes weak so it can not provide oxygen and nutrient intake on the nerves. In the end, nerve cells become damaged.
While other factors that play a role in diabetic neuropathy are genetic factors, nerve inflammation caused by autoimmune responses, and the habit of consuming alcohol and smoking, which causes damage to the nerves and blood vessels.
The risk of diabetics experiencing neuropathy will be higher if:
- Diabetes suffered for a long time with blood sugar levels are not well maintained.
- Experiencing kidney disorders so that toxins in the blood increases and can cause nerve damage.
- Smoke. Smoking habits can cause the arteries to narrow and harden, resulting in reduced blood flow to the legs. This condition makes the wound more difficult to heal.
- Have excess body weight.
Diagnosis of Diabetic Neuropathy
The initial diagnosis of diabetic neuropathy is based on symptoms, medical history, and physical examination. To establish the diagnosis, performed several other investigations, including:
- Examination Of Nerve Conductivity Speed (KHS), to assess the speed of nerve impulse by the groom on the hands and feet.
- Examination of nerve responses to changes in temperature and vibration.
- Examination of the autonomic nervous system, to detect the occurrence of autonomic neuropathy in patients showing symptoms. In this examination, the patient's blood pressure measurement in various positions, and also assessed the ability of the patient's body to sweat.
- T filament tests to check sensitivity to touch.
- Electromyography test (EMG), to measure the magnitude of electrical impulses in the muscle. This examination is performed simultaneously with KHS examination.
Diabetes Neuropathy Treatment
Treatment of diabetic neuropathy is done with the aim of slowing the progression of the disease, relieve pain and overcome complications, and restore body function. The development of this disease can be slowed by maintaining sugar levels according to age, duration of diabetes, the emergence of other health problems if any, and the health condition of the patient as a whole.
Safe sugar levels for diabetics under the age of 59 years are between 80 and 120 mg / dL, whereas safe sugar levels in diabetics aged over 60 years or have other medical conditions are 100 to 140 mg / dL
Another way to slow the development of diabetic neuropathy is to keep blood pressure, do a lot of physical activity, stop smoking, avoid alcohol, maintain a balanced weight, and apply a healthy diet.
Medicines are commonly given to overcome pain, muscle cramps, and other symptoms that may arise, including:
- Antidepressants, such as duloxetine, nortriptyline, or despiramine.
- Antikejang, such as gabapentin, carbamazepine, or pregabalin.
- Lidocaine in the form of patches.
- Cream capsaicin.
To restore body function and overcome the complications that arise, here are some kinds of treatment:
- To overcome low blood pressure (hypotension), patients are encouraged to apply a healthy lifestyle, drink plenty, and do a sitting position or stand slowly. In addition, the use of a corset for the stomach or compression socks is also recommended by the doctor. In orthostatic hypotension, a number of drugs can be used to treat the symptoms.
- For digestive problems, in addition to medicines for digestion, doctors will advise sufferers to change their diet, such as reducing fiber and fat, eating soft and easily digested foods, and eating more often in small portions.
- For problems associated with the urinary tract (especially loss of bladder control), can be treated with antispasmodic drugs, prolonged technique of urination, and the installation of pessaries or rings inserted into the vagina to prevent urine leakage/bed wetting.
- For sexual dysfunction problems in men, can be treated with sildenafil, tadalafil, or vardenafil drugs. But these drugs are not necessarily safe for everyone. Another way that can be done is to use a vacuum to increase blood flow to the penis. For dry vaginal problems in women, can be overcome with a special lubricant vagina.
Complications of Diabetic Neuropathy
Serious complications that can arise from diabetic neuropathy disease are:
- Decreased sensitivity to symptoms of hypoglycemia (low sugar levels) that appear.
- Digestive problems, such as constipation, diarrhea, and gastroparesis.
- Excessive sweating or otherwise decreased due to sweat glands that are not functioning normally.
- Urinary tract infections and urinary incontinence.
- Charcot joint disease, a condition characterized by swelling of the joints, decreased sensation, to defects or joint changes.
- Death tissue legs. Infection that spreads due to diabetes can cause leg tissue to die of untreatable and should be amputated.