Diabetes is a disease in which blood glucose (sugar) levels are very high.Over time, a high level of blood sugar (glucose) can damage nerves throughout the body, giving rise to what is known as 'diabetic neuropathy'.This affects, more frequently, the nerves of the legs and feet.
In an interview with Infosalus, Dr. José Ángel Díaz Pérez, specialist in Endocrinology and Nutrition and member of the Spanish Diabetes Society (SED) thus explains that high blood glucose concentrations in people with diabetes in a timeThey produce damage to the pods of the nerves.
"This can occur with the nerves that control the muscles responsible for the voluntary movement (the peripheral nervous system), such as the muscles of the legs and hands; and with the muscles of the autonomic nervous system (which contract involuntarily), Like those who innervate the stomach, heart, urinary bladder, the penis, among others, "says also the Secretary of the Diabetic Foot Group of the thirst and worker of the San Carlos Clinical Hospital (Madrid).
As laments, it is a fairly frequent complication among diabetic people, and especially in the case of women, while indicating that it increases with the years of evolution of diabetes and above all it is related to the degree of metabolic control(It occurs more often in people with higher levels of glycosylated hemoglobin)."If we consider initial diabetic neuropathy (with hardly any symptoms, but with alterations in the electromograms tests) and established neuropathy (already with symptoms), the prevalence could be between 22-67%, depending on the patient's age," he adds.
But why does it occur?Dr. Díaz Pérez points to one of the potential mechanisms of nerve lesions in diabetes, hyperglycemia, responsible for the production of toxic metabolites (derived from high metabolism of glucose), which attack the myelin sheath of the nerve, cause alterationsof the small blood vessels that irrigate the medium, and generate anomalies of the molecular pathways of the cells (diacigglycerol, kinase protein C, channels of the sodium).
"So that it can be better understood we always compare the nerves with ancient electrical cables: the white outside that protects the cable would be like the myelin sheath. All the above mechanisms make this pod deteriorate and the cable that goes insideIt is exposed and this is how symptoms occur, "says the specialist of the Spanish Diabetes Society.
However, the specialist in endocrinology and nutrition points out that there are many types of diabetic neuropathy, but can be classified into two groups: peripheral nervous system neuropathy and autonomic neuropathy.
"Within the first group, the most frequent is distal peripheral polyneuropathy that affects the nerves of the legs and feet. There are other important types such as nerve neuropathies that control the muscles of the eye, that of the facial nerve, theof the medium nerve (which produces the carpal tunnel syndrome in the hands) and other less frequent types such as the neuropathy of the peroneal nerve to the diabetic amiotropia (which produces muscle atrophy on the thighs), "he adds.
In turn, Díaz Pérez details that within the regional neuropathies there are also many types depending on the affected organ, ranging from the alteration of the pupils (patients are dazzled with the intense light);to excessive sweating by involvement of the sweat glands;the difficulty for stomach emptying (gastroparesis), constipation and diarrhea;tachycardia and hypotension (by affectation of the nerves of the heart);The difficulty forproper emptying of the urinary bladder;and erectile dysfunction in le a male and the lack of excitation and orgasm disorders in women.
Symptoms of diabetic neuropathy
As for what the symptoms of diabetic neuropathy may be, the expert of the San Carlos Clinical Hospital emphasizes that if we stick to the most frequent way, peripheral diabetic polyneuropathy, it produces two types of symptoms:
.- Positive symptoms such as pain (sometimes very intense), numbness, tingling and tingling and heat.
.- Negative symptoms include the lack of sensitivity in legs and feet (in the form of sock) that affects the different types of sensibilities (pain, pressure, vibration, cold and heat).
With all this, according to the member of the Spanish Diabetes Society, the best way to prevent this damage to the nerves, a consequence of diabetes, is trying optimal control of glycemia levels with diet, exercise, drugsand glycemic self -control.In addition, it says that other potentially harmful factors should be avoided for nerves, such as tobacco and excessive alcohol consumption.
In his opinion, apart from trying to control the symptoms of the patient (especially pain), patient education is of the utmost importance to avoid one of the most feared complications of diabetic neuropathy, foot ulcers, which together withBlood vessel disease can lead to the end of amputations."We must instruct all patients in the care of the feet (cleaning, inspection, adequate footwear, frequent visits to the podiatrist, among other measures)," concludes Dr. Díaz Pérez.
