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Diabetes Information

Diabetic Neuropathy

Diabetic neuropathy is a disorder in the nerves, usually seen as a complication in diabetic patients. It is often characterized by numbness and painful tingling sensations in the extremities, such as the hands and feet, arms and legs. Diabetic neuropathy may also lead to complications of the heart, reproductive organs, and the gastro-intestinal tract, having symptoms such as indigestion, loose bowel movement or diarrhea, constipation, vertigo, bladder problems and even impotence. In severe cases, it can cause sudden weakness and abnormal loss of weight, leading to depression. There are several treatments available although usually to ease the symptoms exhibited and not really to cure the underlying cause, which is diabetes.

Diabetic neuropathy symptoms vary. It starts with the loss of feeling in the feet and sometimes a warm feeling followed by painful tingling sensations on the toes and feet. Some do not feel any signs of neuropathy at the start but when it becomes more severe, and then it suddenly exhibits itself. Unfortunately, since the symptoms are unnoticeable at first, it is usually too late to undergo treatment when it is finally detected. Diabetic patients are advised to avoid any injury or wound on their body as well as regularly inspect their hands, feet and legs for any lesion. This is because any injury to the extremities may not be felt because of the neuropathy and end up in infection and even gangrene if not treated early.

Extensive research has shown that these neurological symptoms are caused by a prolonged elevation of glucose levels in the blood. Too much glucose can damage the peripheral nerves in the body, leading to a loss of sensation and the inability to send and receive signals. It can also lead to the damage of blood vessels, especially the capillaries, blocking the supply of oxygen and nutrients to some parts of the body. If this happens, the cells of that part of the body, usually the feet, will die and usually lead to infection and gangrene. Some patients are also genetically predisposed to having nerve diseases as compared to others.

The precise pathway of how blood glucose damages the nerves is still highly debatable. It is hypothesized that when the levels of blood sugar are high, glucose is broken down into sorbitol, a glucose alcohol, instead of its normal pathway of becoming carbon dioxide and water. Sorbitol is thought to compete with myo-inositol, a substance responsible for the chemical structure of nerves, in the maintenance of nerves, leading to its destruction.

Diabetic patients are very susceptible to having nerve problems especially if they are having a hard time maintaining their blood glucose levels within normal limits. Clinical neuropathies usually appear within the first years following a positive diagnosis for diabetes. The risk increases as the diabetes continues. In fact, diabetic neuropathy is one of the common diabetes complication seen in at least seventy percent of people having diabetes.

Several risk factors also contribute in the early development of diabetic neuropathies. Among these risk factors are smoking, problems with controlling levels of blood glucose, and being over the age of forty. Studies are being made on the effect of elevated glucose levels on nitrous oxide and proteins found in the blood vessels. Nitrous oxide is responsible for blood vessel dilatation. An excess of glucose over a long period of time may cause nitrous oxide to decrease, thus constricting the blood vessels that supply the nerves and leading to its damage. Also, when blood glucose is increased, it supposedly attaches itself to the circulating lipoproteins, alters its function and structure to affect blood circulation. But there is still a lot of ongoing research about these pathways and as to finding what really causes neuropathies to happen in diabetes.



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