Diabetes is a metabolic disease characterized by high blood glucose levels due to deficiency in insulin secretion or insulin action. Diabetes is fast becoming an epidemic. From 1980 to 2008, the number of Americans with diabetes has more than tripled (from 5.6 million to 18.1million). Diabetes symptoms include delayed healing of wounds, increased thirst, hunger, and frequent urination. It is very important to achieve blood glucose control through oral medicines or injectable insulin in order to control symptoms. If glucose levels are not managed appropriately, one might end up having multiple complications.
Diabetic neuropathy is a very common complication of diabetes that causes nerve damage due to high blood glucose levels. Diabetes is considered to be one of the leading causes of peripheral neuropathy in developed countries, including the U.S. Diabetic neuropathy is responsible for 50 to 70 percent of non-traumatic amputations.
A patient suffering from diabetic neuropathy can lose speech or the sense of hot and cold. Nausea, vomiting, and muscle breakdown are other symptoms of this condition.
Peripheral neuropathy caused by diabetes most commonly affects legs and feet. Pain, tingling, and burning sensation, muscle cramps, and numbness in the legs are all symptoms of peripheral neuropathy.
The pathology behind peripheral neuropathy is that the inner lining of the blood vessels supplying the nerves gets injured due to high blood glucose levels. Small blood vessels are commonly involved in peripheral neuropathy. The symptoms correspond to nerves involved; they may vary from impotency, erection problems, loss of bladder control, numb legs, to poor vision. Raised glucose levels may cause some pathological changes in the nerves, resulting in neuropathy. Insulin is required to facilitate glucose entry into cells; this is very essential for the normal functioning of the cells. When nerves of the digestive tract are affected, elimination of food from stomach is delayed. This is called gastroparesis (paralysis of stomach).
Treatment of neuropathy includes strict glucose control and alleviation of pain. FDA has approved Duloxetine® and pregabolin for diabetic neuropathy. Strict glucose control can also reverse the pathogenesis of recent origin.
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