Wednesday, June 19, 2019

Managing

“Managing your diabetes is not a science. It is an art.” (Anonymous)

Diabetic neuropathy is nerve damage that is caused by diabetes. Nerves are bundles of special tissues that carry signals between your brain and other parts of your body. Over time, high blood glucose levels, also called blood sugar, and high levels of fats, such as triglycerides, in the blood from diabetes can damage your nerves. 

High blood glucose levels can also damage the small blood vessels that nourish your nerves with oxygen and nutrients. Without enough oxygen and nutrients, your nerves cannot function well. Your symptoms and treatments depend on which one of the four diabetic neuropathies you have. Symptoms can range from pain and numbness in your feet to problems with the functions of your internal organs such as your heart and bladder.

If you have diabetes, your chance of developing nerve damage caused by diabetes increases the older you get and the longer you have diabetes. Managing your diabetes is an important part of preventing health problems such as diabetic neuropathy. You are also more likely to develop nerve damage if you have diabetes and: are overweight, have pressure, have high cholesterol, have advanced kidney disease, drink too many alcoholic drinks, or smoke. Here are the four types of diabetic neuropathy. Do you have one of these, or know of someone who does?

Peripheral Neuropathy -Peripheral neuropathy is the most common form of neuropathy caused by diabetes. It affects nerves leading to your extremities—to your feet, legs, hands, and arms. The nerves going to your feet are the longest in your body. Because the nerves leading to your feet are so long, it’s most often these nerves that are damaged. There are more of them to be damaged. This nerve damage can lead to the foot problems often associated with diabetes, including foot deformities, infections, ulcers, amputations, and bone and joint pain. The following symptoms may exist: a tingling or burning feeling, sharp, jabbing pain that may be worse at night, extreme sensitivity to the lightest touch — for some people even the weight of a sheet can be agonizing, muscle weakness, or loss of reflex response.

 Proximal Neuropathy-Proximal neuropathy is a rare and disabling type of nerve damage in your hip, buttock, or thigh. The damage typically affects one side of your body and may rarely spread to the other side. Symptoms gradually improve over a period of 6 to 12 months. Proximal neuropathy may lead to significant weight loss. Sometimes, proximal neuropathy can involve nerve pain especially pain that shoots from the low back and down the leg.  Proximal neuropathy is the second most common type of diabetic neuropathy. It usually affects elderly people with diabetes.

Autonomic Neuropathy- There are many functions that happen in your body without you thinking about them: your heart pumps, you breathe, and your stomach digests food. Those actions are controlled by the autonomic nervous system. More than 30 percent of people with diabetes have autonomic neuropathy. Autonomic neuropathy is damage to nerves that control your internal organs, leading to problems with your heart rate, blood pressure, digestive system, bladder, sex organs, sweat glands, eyes, and ability to sense hypoglycemia. Diabetes can affect the nerves in any of these areas, possibly causing:

·        A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)

·        Bladder problems, including frequent urinary tract infections or urinary incontinence or urinary retention

·        Constipation, uncontrolled diarrhea or a combination of the two

·        Slow stomach emptying (gastroparesis) leading to nausea, vomiting, sensation of fullness and loss of appetite

·        Difficulty swallowing

·        Erectile dysfunction in men

·        Vaginal dryness and other sexual difficulties in women

·        Increased or decreased sweating

·        Sharp drops in blood pressure when you rise from sitting or lying down, that may cause you to feel lightheaded or faint (orthostatic hypotension)

·        Problems regulating your body temperature

·        Changes in the way your eyes adjust from light to dark

·        Increased heart rate when you're at rest

 
Focal Neuropathy- Focal neuropathy, which comes on suddenly, most often affects nerves in the head (especially ones that go to the eyes), hand, torso, and legs. The most common type of focal neuropathy is carpal tunnel syndrome , in which a nerve in your wrist is compressed. Although less than 10 percent of people with diabetes feel symptoms of carpal tunnel syndrome, about 25 percent of people with diabetes have some nerve compression at the wrist.

“Diabetes is like a roller coaster. It has its ups and downs, but it's your choice to scream or enjoy the ride.” (Anonymous) [i]



[i] Sources used:
·        “Diabetic neuropathy types: Symptoms tell the story” By Mayo Clinic Staff

·        “Diabetic Neuropathy” by National Institute of Diabetes and Digestive and Kidney Disease

·         “Types of Diabetic Neuropathy” by Daniel J. Toft

·        “What Is Diabetic Neuropathy?” By National Institute of Diabetes and Digestive and Kidney Disease

 

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