Diabetic neuropathy is a combination of the syndromes of damage to various parts of the peripheral and autonomic nervous system that occurs against the background of metabolic disturbances in diabetes mellitus and complicates its course.
According to statistical data, being one of the most frequent and serious complications of diabetes, various forms of diabetic neuropathy are diagnosed in almost half of all patients with diabetes mellitus.
The main cause of the development of diabetic neuropathy is a chronically elevated blood glucose level, which ultimately leads to a change in the structure and functioning of nerve cells. Due to the violation of carbohydrate metabolism in diabetes mellitus, patients receive microangiopathies – pathological changes in the vessels of the microcirculatory bed, due to which the normal blood supply of the nerves is disrupted. As a result of multiple metabolic disorders, edema of the nervous tissue develops, all metabolic processes in nerve fibers are disrupted, nerve impulses are worsened, the antioxidant system is inhibited, which leads to the accumulation of free radicals that have a harmful effect on nerve cells, and development of autoimmune complexes begins, which eventually can lead to an atrophy of nerve fibers.
There are a number of factors that increase the risk of developing diabetic neuropathy:
- advanced age,
- lengthy experience of diabetes mellitus,
- the phase of decompression,
- increased blood pressure,
- overweight and obesity,
- smoking, drinking alcohol.
Diabetic neuropathy is classified in several ways. A number of authors distinguish four main types of diabetic neuropathy:
- peripheral neuropathy – one of the most common species, in which there is damage to the nerve fibers of the limbs, with lower limbs being affected more often,
- autonomic neuropathy – which disrupts the work of many internal organs – the heart, stomach, intestines, sexual dysfunction develops,
- proximal neuropathy – characterized by severe pain in the thighs, buttocks and hip joints,
- focal neuropathy – at which local lesions of individual nerve fibers occur.
In the treatment of diabetic neuropathy, the sequence is very important. Since the disease is a concomitant primary – diabetes mellitus of the first and second types, first of all, it is necessary to transfer diabetes mellitus to the stage of compensation. Correction of blood glucose level is carried out by an endocrinologist or a diabetologist with the appointment of insulin or antidiabetic drugs. Regular monitoring of blood sugar levels is necessary. In addition, for a complex treatment of a patient, a special diet should be developed and the physical load regime determined. If the patient is obese, it is required to develop a program to reduce excess weight. No less important is the monitoring of the level of blood pressure. It is easy to carry out even without the supervision of a doctor, independently. You can find pressure-measuring devices in many Canadian pharmacies.
Symptomatic treatment depends on the type of diabetic neuropathy and consists of the intake of B vitamins, which possess neurotrophic action, antioxidants, magnesium, and zinc preparations. When diabetic neuropathy is accompanied by severe pain, doctors resort to the appointment of analgesics and anticonvulsants.
Specialists widely use physiotherapy methods in the treatment of diabetic foot neuropathy. It can be electro stimulation of nerves, magneto therapy, laser therapy, acupuncture, therapeutic exercise. Patients with a predominant leg injury recommended thorough care of the feet, moisturizing and wearing comfortable shoes, eliminating the formation of calluses.