Neuropatía diabética
A Diabetic Neuropathy disorder associated with diabetes mellitus. This condition is believed to result from diabetic microvascular injury that involves small blood vessels supplying nerves.
La presión arterial alta tiene la capacidad de dañar las fibras nerviosas en el cuerpo, pero en casos de neuropatía diabética, los daños ocurrirán en la pierna y el pie.
The symptoms of diabetic neuropathy will depend on the affected nerves and will range from numbness and pain experienced in the extremities to problems associated with the heart, blood vessels, urinary tract and digestive system.
For some patients the symptoms of diabetic neuropathy are mild and for others the condition is disabling, painful and in some cases fatal. Diabetic neuropathy is a serious complication but can be controlled.
Síntomas
The symptoms of diabetic neuropathy will depend on the nerves affected. Some patients with damaged nerves will have no symptoms while others will experience pain, tingling and numbness.
The symptoms will be mild initially and this is because the nerve damage will occur over a long period of time and the mild cases might go for long periods without being noticed.
Most of the symptoms will involve involuntary, autonomic, motor or sensory nervous systems. In patients with focal neuropathy, the pain experienced can be severe and sudden.
Symptoms that are associated with diabetic neuropathy include:
> DebilidadDebilidad
> Sequedad vaginal en las mujeres y disfunción eréctil en los hombres
> Problemas relacionados con la micción
> Estreñimiento y diarrea
> Vómitos, indigestión y náuseas
> Desmayos y mareos como consecuencia de la caída de la tensión arterial después de estar sentado o de pie.
> Algunos pacientes experimentan entumecimiento, hormigueo y dolor en manos, brazos, dedos de las manos, piernas y dedos de los pies.
> Desgaste de los músculos de manos y pies.
Hay síntomas que no son neuropáticos pero que acompañan a esta enfermedad, como la depresión y la pérdida de peso.
Tipos de neuropatía diabética
La neuropatía diabética se clasifica en diferentes categorías: autonómica, proximal, periférica y focal. Cada una de estas categorías afecta a distintas partes del cuerpo.
Neuropatía autonómica
This type of diabetic neuropathy causes alterations in the digestive system, bowel and bladder function, respiration, and sexual response this condition also affects nerves that serve the heart, lungs and eyes.
This condition is known to cause hypoglycemia unawareness which is a condition where the patient will no longer get the low blood glucose level symptoms
Neuropatía proximal
Esta enfermedad provoca dolor en las caderas, las nalgas y los muslos, y se sabe que causa debilidad en las piernas.
Neuropatía focal
Este tipo de neuropatía diabética causa debilidad muscular y dolor por debilitamiento del hueso o grupo de nervios. Cualquier nervio del cuerpo corre el riesgo de verse afectad
Neuropatía periférica
Este tipo de neuropatía diabética es la más común de las cuatro y causa pérdida de sensibilidad o dolor en pies, piernas, brazos y manos.Anyone who notices a sore or cut on the foot that does not seem to heal should see a doctor especially if it only gets worse with time.
Other signs that a person should see a medical practitioner include weakness, pain, tingling or burning sensation in the feet or hands, dizziness, alteration of urination, digestion or sexual function.
The symptoms will not always be as a result of nerve damage, they might be caused by other serious conditions that require immediate medical attention.
Causas
Diabetic neuropathy can be caused by the prolonged exposure of nerves to high blood sugar levels. In this situation the exact cause is difficult to pinpoint but there are a number of factors that are believed to cause the condition such as the complicated interaction between the blood vessels and the nerves.
High blood sugars will disrupt the ability of the nerves to transmit signals. These elves will also weaken the small blood vessel walls that supply nutrients and oxygen to the nerves.
Other factors that are known to contribute to diabetic neuropathy include nerve inflammation which is caused by an autoimmune response.
This is where the immune system in the body treats a certain part of the body as foreign organism and attacks it. Genetic factors are also associated with diabetic neuropathy and are unrelated to neuropathy but play a role in the development or susceptibility to nerve damage.
Alcohol abuse and smoking will both damage blood vessels and nerves and put an individual at a greater risk of developing diabetic neuropathy.
Factores de riesgo
Cualquier persona con diabetes puede padecer neuropatía diabética, pero existen factores que aumentan el riesgo de desarrollarla.Poor blood sugar control has been found to increase diabetic neuropathy risk because it can cause nerve damage. The best way to prevent any complications is to maintain the blood sugar at target ranges.
The duration an individual suffers from diabetes is also related to diabetic neuropathy because the longer someone has diabetes the higher the risk of developing diabetic neuropathy becomes.
Kidney disease caused by diabetes might lead to the increased levels of toxins in the body leading to damage of nerves. Smoking has been found to narrow and harden arteries and this decreases the blood flow to the feet and legs.Body overweight has also been identified as a factor that increases the risk of developing diabetic neuropathy.
Diagnóstico
La neuropatía diabética se diagnostica a partir de los síntomas descritos por el paciente, su historial médico y una exploración física. El médico comprobará la fuerza muscular, los reflejos tendinosos y la sensibilidad a las vibraciones, la temperatura y el tacto.
Otras pruebas que pueden realizarse son la prueba del filamento, estudios de conducción nerviosa, electromiografía, pruebas autonómicas y pruebas sensoriales cuantitativas. Se recomienda que todos los pacientes diabéticos se sometan a exámenes completos de los pies al menos una vez al año.
Tratamiento
Diabetic neuropathy has no known cure and the treatment process will be aimed at slowing the progression of the disease and improving some of the symptoms.
Relieving pain to improve the quality of life and allow the patient to handle normal life activities, and managing the complications that might arise and restoring function. There is an increased risk of feet injuries due to loss of sensation and infections can lead to ulcerations which will need amputation.
