The recommendations of neurologist Adriana Ninoiu (Cardio Help) for the prevention of cases of diabetic neuropathy
50% of patients with diabetes develop diabetic peripheral neuropathy, a condition betrayed by numbness or tingling in the limbs, muscle weakness and which, sometimes, can degenerate into complications. Because of the high frequency, patients with type 2 diabetes should go for an early neurological evaluation, says Dr. Adriana Ninoiu, neurologist at Cardio Help Craiova, and patients with type 1 diabetes can be affected.
What is peripheral neuropathy and how does it manifest itself?
Dr. Ninoiu explains: “Peripheral neuropathy is the consequence of affecting the peripheral nervous system, the one that connects the central nervous system (brain and spinal cord) and the extremities of the body (hands, arms, legs)”.
The peripheral nervous system has several types of nerves. Some of them are sensitive nerves, responsible for transmitting sensations, such as pain, vibration, temperature. Another type is the motor nerves – responsible for muscle control. Another category is that of the autonomic nerves – which regulate functions such as digestion, blood pressure, sweating or heart rate.
What causes peripheral neuropathy?
“The causes of peripheral neuropathy are diverse. But among the most important are diabetes, the most common cause of peripheral neuropathies, cervical and lumbar discopathy, spondylosis, disc herniations, autoimmune diseases such as lupus, rheumatoid arthritis, vitamin deficiency – especially vitamin B12, excessive alcohol consumption” , says the center’s specialist Cardio Help.
Symptoms depend on the type of nerves affected. Patients may experience numbness, tingling, burning, stinging, muscle weakness or pain in the hands or feet, even difficulty walking. In extreme cases, even paralysis.
Diabetic neuropathy is the most common complication of diabetes
Diabetic neuropathy is the most common complication of both type 1 and type 2 diabetes. 50% of patients with diabetes develop diabetic peripheral neuropathy, a form that manifests symmetrically, bilaterally.
Numbness, tingling or burning sensations appear on the soles, most frequently, which go up “in the stocking” to the ankle level, and “in the glove” to the hand level. Patients can also feel a decrease in thermal sensitivity, a decrease in muscle strength, difficulty walking or maintaining balance, muscle cramps or the feeling of restless legs”, says Dr. Adriana Ninoiu.
The main cause is the increased level of blood glucose, which produces the alteration of the small blood vessels that feed the peripheral nerves and implicitly damage these nerves.
The risk factors that contribute to the appearance of diabetic neuropathy are poor glycemic control, elevated LDL cholesterol and triglyceride values, obesity, high blood pressure, smoking, alcohol consumption and advanced age, adds the neurologist.
Diabetic patients should schedule a visit to the neurologist
The symptoms can make their presence felt even in the prediabetes stage. Therefore, an early neurological evaluation is recommended in the case of the diagnosis of type 2 diabetes and 5 years after the diagnosis of type 1 diabetes, says Dr. Ninoiu.
The neurological evaluation involves a detailed history, a complete neurological examination with the examination of thermal, tactile, pain sensitivity through specific tests, muscle strength testing, electromyography – which measures the speed of nerve conduction in the skeletal muscles.
Diabetic neuropathy can become complicated, ulcerations and skin infections can occur, which can easily lead to the amputation of the fingers or the leg. This condition is known as diabetic foot or Charcot foot.
The doctor’s recommendations for the prevention of neuropathy
“The prevention of diabetic neuropathy and complications is essential for the diabetic patient. In this sense, we recommend a hypoglycemic diabetic diet, following 3 main meals with 2 snacks, a diet rich in vitamin b12 and avoiding hypoglycemia. It is important to maintain normal blood sugars and daily blood sugar control, as well as the periodic control of glycosylated hemoglobin. It is also recommended to avoid alcohol or smoking, which contribute to nerve damage. The patient must follow the treatment indicated by the doctor and treat all risk factors – hypertension, dyslipidemia, obesity, maintaining optimal foot hygiene with nail care and, last but not least, medical information,” says doctor Adriana Ninoiu.
“It is good for patients to know the symptoms of neuropathy, because adequate information makes them go to the doctor more quickly and thus benefit from therapy in time”, says the specialist.
The treatment of neuropathy involves, first of all, the treatment of the underlying disease – diabetes. There are also therapeutic options that can prevent the occurrence of neuropathy – treatment with alpha-lipoic acid, denfotiamine, but also specific treatment for pain. Electrotherapy, massage or physical therapy may also be beneficial in some cases.
Cardio Help appointments: 0251 708 626
2023-09-06 12:08:02
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