What is diabetic neuropathy?
Diabetic neuropathy refer to a group of diseases that affect all types of nerves, including peripheral, autonomic and spinal nerve.
Etiology of Diabetic nephropathy
- elevated blood glucose levels over a period of years.control of blood glucose level to normal or near to normal levels, decrease the incidences of neuropathology
Diabetic nephropathy classification
1.sensorimotor polyneuropathy ( peripheral neuropathy )
2.autonomic neuropathy
What is sensorimotor neuropathy?
It's mostly affect the distal portion of the nerves especially lower extremities
Signs and symptoms
1.paresthesias
2.Burning sensation
3.feet become numb
4.Decreased sensation of light touch
5. Decreased sensation of pain and temperature
On physical examination a decrease in deep tendon reflexes is found, some patient have no symptoms of neuropathy, physical examination may be the only indication finding neuropathy changes.
Diabetic nephropathy treatment
1. Intensive insulin therapy and control of blood glucose levels delay or slow the progression of neuropathy
2. Pain particularly of the lower extremities, pain resolve spontaneously within 6 month
- some patient pain persists many years.analgesic agents used to treat the pain
- Duloxetine and pregabalin used to treat painful Diabetic peripheral neuropathy
What is autonomic neuropathy?
In autonomic neuropathy, autonomic nervous system dysfunctions and affecting almost every organ and system of the body
Signs and symptoms
Cardiac sign and symptoms
1. Slightly tachycardia
2.orthostatic hypotension
3.painless myocardial and infraction
Gastrointestinal signs and symptoms
1. Delay gastric empty
2.Bloating
3. Nausea
4.vomiting
5. Constipation
6. Inconsistent absorption of glucose from food
Renal signs and symptoms
1.Urinary retention
2.Decrease sensation of bladder fullness
3. Development of urinary tract infection
Diabetic nephropathy treatment
1. Alleviating symptoms, modify and management of risk factor
2. Detecting painless cardiac ischemia
3.frequent blood glucose monitoring
4. Constipation is treated by high fiber diet and adequate hydration and laxative agent, enemas necessary if constipation is more severe
5.Education about avoiding strenuous exercise can be provided
6. Use of sympathomimetic agent to stimulate an autonomic response
Prevention
1. Management of high blood pressure and treat your higher level of blood glucose with effective treatment
2. Maintain healthy weight gain
3. Avoid smoking and alcoholism
4. Follow up physician order regularly
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