is neuropathy curable -diabetic neuropathy-causes, diagnoses and treatment.
Is neuropathy curable? So what then causes
diabetic neuropathy? The pathology can be detailed under four arms. The first
is micro vascular disease or microangiopathy. What is that all about? Well as with most diabetes complications, the
major culprit here is sugar.
Because
diabetes is characterized by the bodies’ inability due to lack of insulin or
insulin resistance to take up blood sugar, nerve fibers experience an overlong
exposure to it. This not only affects the ability of the nerves to transmit
signals but also weakens and constricts the walls of the small blood vessels or
capillaries supplying the nerves with nutrients and oxygen such that supplies
of both to the nerves is diminished.
It
is this nerve damaging condition that is known as microangipathy. Now, since
blood vessels require normal nerve function and nerves depend on adequate blood
flow, failing nerve function leads to further deterioration in the blood
circulatory system.
The
sets up a cycle that eventually snowballs into the complications of diabetic
neuropathy. Secondly, we have the Polygon pathway or sorbet or altos pathway.
This pathway is fingered as a likely agent in diabetic complications that
result in micro vascular damage to nervous tissue.
It
is activated by elevated glucose levels and increases reactive oxygen radicals
and sorbet. This decreases the activity of plasma membrane NA+/K+ATP ace pump
required for nerve function, thus contributing greatly to the neuropathy.
Advanced
glaciated end products, product of a non-enzymatic covalent bonding with
proteins induced by elevated intracellular levels of glucose, is another factor
in the onset of DN. This bonding alters the protein structure and interferes
with their function.
Lastly
the increase levels of glucose leads to an increase in intracellular
diacyglycerol. This activated protein kinas’ C or PKC an inhibitor of neuronal
blood flow and thus nerve conduction. Apart from excess sugar in the blood
stream, other risk factors for diabetic neuropathy are the length of time one
has the diabetes.
With
the risk of coming down with diabetic neuropathy increasing the longer one has
diabetes. In addition to this, being overweight-that is having a body mass
index greater than 24 is another risk factor for developing diabetic
neuropathy.
Further
kidney disease may equally increase the toxins in the blood and so contribute
to nerve damage. Furthermore, since smoking constricts and hardens the
arteries, reducing blood flow to the legs and feet, it makes it more difficult
for wounds to heal and causes damage at the same time to the peripheral nerves.
Thus smoking is also a risk factor for getting diabetic retinopathy.
There
are several serious complications associated with diabetic neuropathy. First,
anyone suffering from the disease runs the risk of limb loss. This happens
usually when nerve damage causing a lack of feeling in the feet, mean that
sores or cuts may go unnoticed, and as such become ulcerated or infected.
Where
such infections spread to the bone, become gangrenous and untreatable,
amputation of the affected toe, foot or leg may be the only solution. Another
complication that may arise is urinary tract infection. Where damage to the
nerves that control the bladder prevents it from emptying out completely,
bacteria can gain access to and multiply in the bladder and kidneys leading to
the infections.
In
addition to that, the ability to detect when you need to urinate or o control
the muscles that release urine may be impaired by nerve damage and as such also
occasion incontinence. Further, the incidence of Charcot joint is another
phenomenon that must be considered.
This
takes place when a joint is usually in the foot because of nerve damage,
deteriorates. The condition is evidenced by swelling, loss of sensation,
instability and at time deformity in the joint. The good news here is that
early treatment can arrest further damage and in fact stimulate healing.
Furthermore,
hypoglyceaemia unawareness, the condition where the sufferer becomes unaware
that is blood sugar has dropped too low- below 70 milligrams per deciliter or
3.9 milimoles per liter can also be occasioned by diabetic neuropathy.
So
too can low blood pressure and digestive problems, where nerve damage to the
digestive system can lead to diarrhea, constipation and gastroperesis. Gastro
paresis is a condition in which the stomach does not empty nor do so too slowly
thus leading to nausea, bloating and loss of appetite.
Again,
increased or decrease sweating is another function that may be impacted by the
condition. Where there is a reduction of or total stoppage of perspiration or
anhidrosis, this can be life threatening as the body is no longer able to use
the sweating mechanism to regulate temperature properly and also assist in
toxins excretion.
Yet
again because autonomic neuropathy often damages the nerves affecting the sex
organs, it may lead to sexual dysfunction in sufferers- erectile dysfunction in
men and lubrication and arousal problems in women.
So
how is a person diagnosed with diabetic neuropathy? This is done based on the
symptoms experienced, a physical exam and the medical history of the person.
The physical exam will take note of tendon, reflexes, and muscle strength and
tone as well as sensitivity to touch, temperature and vibration.
Other
tests which may be conducted are the filament test, to test sensitivity to
touch; the nerve conduction studies to measure how quickly the nerves in the
arms and legs conduct electrical signals; quantitative sensory testing used to
assess nerve response to vibration and changes in temperature; electromyography
or EMG which measure the patient blood pressure in different positions and
sweating ability.
Further
to this, the American diabetic association recommends that all people with
diabetes have a comprehensive foot exam at least once a year to check for foot
and joint abnormalities which may evidence the condition.
So
supposing you get tested for the condition and the tests return positive, what
then is the prognosis for the cure? Well sadly for now, diabetic neuropathy has
no cure. Treatment is however centered on relieving pain, slowing down the
progression of the disease, managing complications arising from it and
restoring function.
How
is this done? Generally, maintaining your doctors recommended sugar range is a
great prevention or slow down tactic that can improve some of the symptoms.
Thus
blood sugar levels of between 80 and 120 mg or 4.4 and 6.7 mm for people age 59
and younger who have another underlying medication condition; between 100 and
140 mg or 5.6 and 7.8 mm for people age 60 and older or those who have other
medical conditions, such as heart, lung or kidney disease has been recommended
by some.
Pain
relieving treatment on the other hand may include anti- seizure medications-
gabapentin, pregabalin and carbamazepine antidepressants- tricyclic
antidepressant medications, serotonin and norepinephrine reuptake inhibitors
and capsaicin cream.
Physical
therapy and acupuncture have also known to relieve pain. Other alternative
treatment forms include the use of alpha-lipoid acid and transcutaneous
electrical nerve stimulation. For other specific complications however for
example sexual dysfunction, the drug sildenafil and for urinary tract problems,
antispasmodic medications may be enlisted.
Apart
from following your doctors advise, further recommendations for slowing down,
nerve damage include following a healthy eating plain, maintaining a healthy
weight, keeping your blood pressure under control, getting plenty of exercise,
stopping smoking and the avoidance of alcohol, or mode racy in drinking it
where allowed.
As
such, notwithstanding the non- availability of a cure, with the uptake of the
foregoing advice and use of available medication, the sufferer can find
relieve, improve his condition and enjoy a better quality of life than he would
otherwise have had.
For
more information on diabetic neuropathy and other diabetes complications; their
causes, tests, diagnoses, prognosis and prevention visit is neuropathy curable
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