Diabetic Neuropathy Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Diabetic neuropathy is a complication of diabetes mellitus which is characterized by nerve disorders, especially in the lower limbs. This disease is experienced by around 50 percent of people with type 1 and type 2 diabetes mellitus. If blood sugar levels are not controlled properly, the condition of diabetic neuropathy will become increasingly severe.
Apart from the nerves in the lower limbs, diabetic neuropathy can also occur in internal organs such as the heart, stomach, intestines and bladder.
In general, there are four types of diabetic neuropathy, namely:
- Peripheral neuropathy, which is a nerve disorder in diabetics that attacks the nerves in the legs and feet, as well as the arms and hands. This type is the most common type of diabetic neuropathy.
- Autonomic neuropathy, which is a nerve disorder that affects internal organs such as the intestines, heart, sweat glands, and eyes.
- Focal neuropathy, which is neuropathy that only affects one nerve. Usually, complaints occur because the nerve is pinched.
- Proximal neuropathy, namely nerve disorders in the pelvis, buttocks, or hips. This type is the most rarely encountered neuropathy.
Symptom
The symptoms of diabetic neuropathy vary widely. Common symptoms are tingling or numbness. These complaints usually start in the soles of the feet. Because the symptoms of this neuropathy appear very slowly, complaints of numbness are sometimes not realized by diabetics. The presence of numbness or tingling should be suspected in diabetics who have injured their feet but do not remember how these injuries could have occurred.
In addition to a feeling of loss of sensation, sometimes diabetic neuropathy actually gives symptoms of pain. The pain is usually felt to be worse at night. Generally, sufferers describe the pain as cramping, burning, or like being slashed.
Not infrequently, neuropathy also causes complaints of muscle weakness. People with diabetic neuropathy have difficulty walking, and their muscles, especially in the calf area, seem to shrink.
If the neuropathy experienced is a type of autonomic neuropathy, complaints of dizziness, low blood pressure, difficulty defecating or diarrhea, and sexual dysfunction can also occur.
Reason
Diabetic neuropathy occurs due to many factors, including:
- Uncontrolled blood sugar
- Elderly
- Uncontrolled hypertension
- Suffered from diabetes for a long time
- High cholesterol
- Smoke
- Habit of consuming alcohol
Apart from these things, it is suspected that genetic factors also play a role in causing diabetic neuropathy.
Diagnosis
Early detection of diabetic neuropathy is done by checking fasting blood sugar and hemoglobin A1C (HbA1C) levels. Diabetics who have high levels of fasting blood sugar and HbA1C are prone to developing diabetic neuropathy.
Furthermore, if there are symptoms that match the condition of neuropathy, the doctor will confirm this by carrying out an electromyography examination. This examination is carried out by a neurologist.
Symptom
The symptoms of diabetic neuropathy vary widely. Common symptoms are tingling or numbness. These complaints usually start in the soles of the feet. Because the symptoms of this neuropathy appear very slowly, complaints of numbness are sometimes not realized by diabetics. The presence of numbness or tingling should be suspected in diabetics who have injured their feet but do not remember how these injuries could have occurred.
In addition to a feeling of loss of sensation, sometimes diabetic neuropathy actually gives symptoms of pain. The pain is usually felt to be worse at night. Generally, sufferers describe the pain as cramping, burning, or like being slashed.
Not infrequently, neuropathy also causes complaints of muscle weakness. People with diabetic neuropathy have difficulty walking, and their muscles, especially in the calf area, seem to shrink.
If the neuropathy experienced is a type of autonomic neuropathy, complaints of dizziness, low blood pressure, difficulty defecating or diarrhea, and sexual dysfunction can also occur.
Treatment
Treatment of diabetic neuropathy requires the cooperation of neurologists and internal medicine specialists, especially endocrinologists. Treatment should include:
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Control blood sugar
This action is the most important thing in the treatment of diabetic neuropathy. Although it cannot cure neuropathy, controlling blood sugar is important to prevent the disease from progressing.
To maintain controlled blood sugar levels, diabetics must do regular physical exercise at least four times a week, adjust their diet (increase fiber and reduce fat), and take medication regularly. If blood sugar is not well controlled, doctors often have to give several combinations of anti-diabetic drugs or insulin.
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Reducing pain
To reduce pain due to diabetic neuropathy, doctors generally give drugs that work on nerve cells, such as gabapentin or amitriptyline. This drug should not be taken on one’s own initiative but must be taken on the advice of a neurologist.
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Overcoming diabetic wounds
The existence of disturbances of sensation in the form of numbness or tingling often causes injuries that are not realized how it happened. Not infrequently these wounds are deep enough. Good wound care is needed to prevent the wound from festering and becoming gangrene.
If erectile dysfunction occurs due to neuropathy, sometimes the doctor will give sildenafil or inject papaverine into the penis. To treat low blood pressure, sufferers are generally advised to drink water and consume more salt.
Prevention
Diabetic neuropathy can be prevented by:
- Control blood sugar. As much as possible, try to keep your HbA1C below 7%, your fasting blood sugar level below 130 mg/dl, and your post-meal blood sugar level below 180 mg/dl.
- Keep blood pressure below 140/90 mmHg
- Do leg exercises for diabetics
- Avoid exposure to secondhand smoke
- Eat foods high in fiber and low in fat
- Maintain ideal body weight
- Check with the doctor at least once every three months