DIABETES (Diabetes Mellitus)
Over half of all diabetics, 60 to 70%, will get neuropathy.
Diabetes is most common complaint and cause of death in diabetes sufferers.
It is very common and increasing. In the UK, over 3.2 million people have it & at least 850,000 people who have it without knowing it. 7.4 per cent of England’s population live with the condition.
“The NHS already spends 10 per cent of its entire budget on diabetes and 80 per cent of this goes on treating complications such as amputation, kidney failure, heart disease and stroke.” NHS
Type 2 is more common. Type 1 diabetes affects 400,000 people in the UK & some people are born with it.
What is Diabetes?
Diabetes is a very serious condition of high levels of the blood sugar glucose. Either the pancreas makes not enough insulin or the cells resist the insulin. Then too much glucose builds up in the blood (called hyperglycemia).
There are two types of diabetes, Type 1 and Type 2. Type 1 commonly starts in childhood, Type 2 in adults.
- Adults: 10% have type 1
- Adults: 90% have type 2
- Children: 98% have type 1
- Children: 2% have type 2
In Type 1 the pancreas does not make any insulin, the powerful hormone that carries sugar into cells,
in Type 2 it is not making enough insulin or the cells are resisting the insulin.
Type 2 diabetes usually develops gradually, going through stages known as insulin resistance and then prediabetes or “metabolic disorder”. Problems with blood-sugar show themselves as tiredness,
Prediabetes without a change of lifestyle usually leads to type 2 within 10 years.
Type 1 diabetes can appear at any time in someone’s life after the destruction of pancreas cells, which produce insulin. It isn’t clear why they have been damaged but may be triggered by an infection.
What Are The Symptoms of Diabetes?
The symptoms of diabetes and its complications include:
- Frequent urination (Polyuria)
- Blurred vision
- Constant thirst (Polydipsia)
- Extreme Fatigue/Tiredness
- Frequent infections
- Cuts and bruises healing slowly
- Tingling or numbness in the hands or feet
- Genital itching or regular episodes of thrush
- Nausea and vomiting
- Unexplained weight loss
- Increased appetite/hunger (Polyphagia)
How Common is diabetic neuropathy
Over half of all diabetics, 60 to 70%, will get neuropathy and it is the most common complaint and cause of death in diabetes sufferers. It starts by affecting feet and hands. So if you are getting pain or numbness in your hands or feet ask your doctor to test you for diabetes and neuropathy.
The causes of diabetes
Usually being overweight and not exercising. A bad diet or a genetic weakness of the pancreas or adrenal glands can also cause it. The excess fat of obesity and fatty diets prevents blood sugar [glucose] from entering the muscle cells, so dangerously increasing blood sugar levels and so in response also raising insulin production, both of which cause widespread damage to the body.
How do I find out if I have it?
By a blood test. You can be tested for changed sugar levels and Haemoglobin A1c (HbA1c). If you are getting older or in an ethnic minority, you may need a saliva test too. Your doctor will be happy to do these tests. http://www.diabetes.org.uk/About_us/What-we-say/Diagnosis-prevention/New_diagnostic_criteria_for_diabetes/
Am I more likely to get type 2?
You have increased risk if you are: Overweight, Getting older (over 40 especially),Not Exercising,In a family with Diabetes.
Diabetes is 6 times more likely for people of South Asian origin, & 3 times higher for those of African origin.]
You have more risk of prediabetes if you are overweight or obese or are aged 45 or older, and/or are :
- lacking exercise
- having close family with diabetes
- Haemoglobin A1c (HbA1c) in high range of 42-47 mmol/mol (6.0 – 6.4%)
- having a family background that is South Asian, African-Caribbean or Middle Eastern
- giving birth to a baby of more than 9 pounds weight
- have gestational diabetes, which starts during pregnancy
- have high blood pressure, 140/90 mmHg or above,
- HDL cholesterol level below 35 mg/dL or a triglyceride level above 250 mg/dL
- having polycystic ovary syndrome (PCOS)
- having prediabetes, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT) on an earlier testing
- having other conditions associated with insulin resistance, such as dark patches of skin, acanthosis nigricans
- having cardiovascular disease (also called heart disease) (CVD)
Other Causes of insulin resistance (glucose intolerance/Impaired Glucose Tolerance (IGT))
Certain diseases; hormones; steroid use; some medications; older age; sleep problems, especially sleep apnea; and cigarette smoking.
Sleep problems, particularly sleep , can heighten the risk of weight gain, prediabetes [insulin resistance] and type 2 diabetes. If you suffer from
trouble with sleeping you should consult with your primary healthcare provider.
Your doctor will be worried about your condition getting worse, so will want to see you regularly for checkups.
Excess blood sugar is very harmful:
causing inflammation and irritation, leading to damage, to the cells
causing infections by feeding damaging microorganisms such as candida and bacteria,
causing peripheral neuropathy by two ways:
breaking down the nerves;
and by injuring the walls of the tiny blood vessels, the capillaries, supplying nerves, especially those in the legs. This can lead to ulceration and necrosis, heart disease, stroke, blindness, kidney failure, lower-limb amputations (it is the most common cause of amputations) and death..
Most people with diabetes, at least 50% but more likely about 60 percent to 70 percent in the longer term, have mild to severe forms of nervous system damage.
It is thought that diabetes damages the peripheral nervous system in two main ways:
- The high levels of glucose associated with diabetes triggers a number of biological changes that cause your nerves to break down.
- The high levels of glucose damage the blood vessels that supply your nerves, which accelerates the breaking down of the nerves.
How is Diabetic Neuropathy Treated
By making the diabetes better, and help to reduce the pain (usually drugs to start with).
NHS Recommendation: “Ensuring everyone with diabetes is offered education on how to manage their condition. At the moment, just one in 10 people who are newly diagnosed are offered it, despite strong evidence education is a cost-effective way of giving people the knowledge they need to manage their condition.”
“Fully implementing the NHS Health Check (which should be offered to everyone aged 40 to 74) to help identify people at high risk of Type 2 diabetes.”
” the nine annual checks recommended by the National Institute of Health and Care Excellence (NICE). ”
Your doctor may send you to the physio
The best way to prevent diabetic neuropathy is stable control of blood sugar. Fluctuations in blood sugar have been shown to aggravate and/or induce neuropathic pain.
- Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells, where it is used as fuel for energy so we can work, play and generally live our lives. It is vital for life
In England, diabetes is the most common cause of peripheral neuropathy.
The condition can also be caused by other health conditions, and by certain medications.
Diabetes Peripheral Neuropathy
Neuropathy that is associated with diabetes is called diabetic polyneuropathy. Between 10% and 20% of people who are newly diagnosed with diabetes have diabetic polyneuropathy.
The longer you have diabetes, the greater your chances of developing diabetic polyneuropathy. It is estimated that half of all people who have been living with diabetes for 25 years or more have diabetic polyneuropathy.
Other risk factors for diabetic polyneuropathy include:
- high blood pressure (hypertension)
- heavy consumption of alcohol
- being 40 years of age or over
- having poorly controlled diabetes
Around one of three diabetic patients is affected by distal symmetric polyneuropathy (DSP) which is serious. It may present with partly excruciating nervepain and can be very debilitating & there can be a risk of death.
Treatment is based on four cornerstones: (1) multifactorial intervention aimed at (near)-normoglycaemia and reduction in cardiovascular risk factors, (2) treatment based on pathogenetic mechanisms (3) symptomatic treatment, and (4) avoidance of risk factors and complications.
Among the pathogenetic treatments only α-lipoic acid and epalrestat are available for treatment in several countries. Neuropathic pain, which is present in 8–26% of diabetic patients, exerts a substantial impact on the quality of life, particularly by causing considerable interference in sleep and enjoyment of life. Non-pharmacologic options such as nerve or muscle stimulation should always be given consideration. Among the centrally acting analgesic drugs for many years mainly the tricyclic antidepressants (TCA), carbamazepine, gabapentin, and opioids have been used to treat neuropathic pain. More recently, significant pain relief has been reported in clinical trials of painful diabetic neuropathy using agents such as the dual selective serotonin noradrenaline reuptake inhibitor (SNRI), duloxetine and the anticonvulsant pregabalin, a specific modulator of the α2δ subunit of the voltage-dependent calcium channels. A promising new anticonvulsant is lacosamide. In future, drug combinations might also include those aimed at symptomatic pain relief and quality of life on one hand and improvement or slowing the progression of the underlying neuropathic process on the other hand. Copyright © 2008 John Wiley & Sons, Ltd.
Link 1 -http://www.diabetes.org.uk/About_us/What-we-say/Diagnosis-prevention/New_diagnostic_criteria_for_diabetes/ paragraph 15
What are the symptoms of insulin resistance and prediabetes?
Usually there are no symptoms. People may have one or both conditions for several years without knowing they have them. Even without symptoms, health care providers can identify people at high risk by their physical characteristics, also known as risk factors. The section “Who should be tested for prediabetes?” lists these risk factors.
Self-management of this condition is also crucial. People with diabetes need to be aware of and monitor blood glucose levels, maintain a healthy weight, eat a balanced diet, avoid smoking and have regular health checks.
“We also need to address the obesity crisis, which is what is fuelling the increase in Type 2, by making healthy food cheaper and more accessible and by making it easier for people to build physical activity into their daily lives.” NHS
PN is Caused by :
& MORENews Complementary medicine can help Peripheral Neuropathy!
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