diabetes and nerve problems.pptx

8/12/2019 Diabetes and Nerve Problems.pptx

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Diabetes and

Nerve Problems


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What is Diabetes?

Diabetes is a condition in which there is too much sugar

(glucose) in the blood. Although sugar is needed to provide

energy for the body, when in excess, it causes problem.

Persons with diabetes have excess sugar because they lack or

have deficient supply of insulin.


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Diabetes

Mild Disease

Ser ious cons equences


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Diabetes Mell itusA Serious Disease

Leading cause of new

cases of blindness

25 times more prone to

eye problems

6 times higher risk for

Paralysis (stroke)

5 times more prone to

Kidney failure20 times more prone to

lower limb amputation

Nerve damage causesloss of sensation

2-3 times higher risk for

heart attack


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The Nervous System

The nerves in our body serve as a communication system.

The nervous system conveys messages from the brain toour

legs, hands, feet and other parts of the body (peripheral nervous

system) internal organs such as heart, stomach and bladder (autonomic

nervous system)

The nervous system sends sensations to the brain so thatappropriate actions can be taken in response

touch, pain, pressure, vibration and temperature

smell, taste, sound, and sight


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Long periods of high blood sugar can damage nerve fibers,

impairing their ability to carry messages to and from the brain

Damaged nerve fibers relay signals (sensations) slowly or dont

relay them at all

Restoration of the blood sugar level quickly to with-in target

range may allow damaged nerve fibers to heal and function

properly again

The Nervous System


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Cause of Nerve Damage

High blood sugar can harm nerve cells in two ways:

High sugar level in blood causes high amount of sugar to

enter the nerve cells. As the nerve cells cannot use all of it,

toxic substances accumulate and affect the nerves' ability to

transmit signals

High blood sugar also damages the small blood vessels that

carry oxygen and nutrients to the nerves


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Diabetes and Nerve Prob lems

Diabetic foot ulcers (common accompaniment to neuropathy) are

a common cause of prolonged hospitalizations


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Parts of the body most commonly affected by nerve problems in

people with diabetes:

Leg, feet and hands

Genitals

Eye muscles

Heart

Stomach

Intestines

Bladder

Parts most often affectedDiabetes and Nerve Problems


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Symp toms o f Diabet ic NeuropathyFeet and Hands

Symptomsinclude various types of uncomfortable feelings

such as:

Tingling, like a feeling of ants crawling or pins and needles.

Numbness and heaviness feeling of walking on cotton

Reduced ability to sense heat and cold

Stabbing or burning pain

A persistent restlessness in the feet and legs

Extreme sensitivity to touch, even light touch

Loss of balance and coordination

Dry skin susceptible to cracks and infections


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Serious burns or foreign body impaction (thorns; pebbles) may

occur without pain

Never walk barefoot. Sharp objects can cause injury at work or

home when you least expect them

Dont underestimate the importance of daily foot inspection and

careespecially if you have nerve problems in your feet

Symptom s o f Diabetic NeuropathyFeet and Hands


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Six pairs of eye muscles work together to turn both eyes in the

direction of your choice. These muscles are controlled by three

pairs of nerves.

If blood sugar control has been poor, one or more of these nervescan be affected and can paralyse one or more eye muscles

causing double vision. This can occur suddenly without warning.

Severe unexplained pain behind the eye may also be due to

diabetic neuropathy

Symptom s o f Diabetic NeuropathyEye Muscles


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Symptom s of Diabet ic Au tonom ic Neuropathy

Stomach and Intestines

Nausea, vomiting, feeling of bloating and lack of appetite, because of

delay in emptying of stomach

Difficulty in swallowing

Diarrhoea or constipation because stagnation due to poor bowelmovement

Weight loss

Urinary Tract and Genitals

infection and incontinence of the bladder due to retention of urine

impotency and loss of libido (sexual response) in men and women

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Heart and blood vessels

Sudden fall in blood pressure on standing and sitting suddenly

Silent heart attacks as the perception of pain of heart attack may be

affected

Abnormal heart beats and irregular pulse

Other

Profuse sweating and inability of the body to control temperature as

the nerves to the sweat gland may get affected

Hypoglycaemia unawareness -the body's normal response to lowblood sugar is impaired, making it difficult for the person to

recognize the symptoms

Symptoms of Diabetic Au tonom ic Neuropathy

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You may also have serious nerve damage without any symptoms

Insist on your doctor examining your nervous system when you

are diagnosed or as soon as possible

See a neurologist (nerve specialist) regularly for examination if

and when advised by your doctor

Symp toms o f Diabet ic Neuropathy

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When to Check for Nerve Prob lems

The overall health of your nervous system should be checked as

part of your regular visits to the clinic

Children >10 years and adults < 30 years within 3-5 years of

diagnosis and thereafter once a year

Adults > 30 years at the time of diagnosis and thereafter once a

year

Those already diagnosed with abnormal findings need to be tested

more frequently as advised by their doctor

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Prevent ing Nerve Damage

Keep blood sugar levels as close to normal as possible to slow

the onset and progression of diabetic neuropathy

Avoid smoking as it worsens circulatory problem increasing the

risk of neuropathy Reduce alcohol drinking as it can worsen neuropathy

Take Insulin, if advised

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Test ing for Nerve Prob lems

Your doctor should ask you about:

Vision problems

Any tingling, unusual pain or numbness

Any change in your ability to sweat Heart palpitations

Bowel problems, such as constipation or diarrhea

Difficulty emptying your bladder

Problems with impotence


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Your doctor will examine you to check for sensations

Thermal threshold to check for warm and cold sensationusing test

tubes filled with hot and cold water

Check reflexesStrike parts of body with a small rubber hammer or

touch parts of body to examine for reflex reactions

Cold pressor testdoctor may ask you to dip your hands in ice cold

water and check for changes in your pulse or heart rate

Blood pressure response on standingdoctor will check BP in lying

down and while standing to see if blood pressure suddenly falls on

standing


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Other Tests

Biothesiometryto check for sensations. Biothesiometer is an

electrical device that varies the intensity of vibrations

Electromyography (EMG) - to check muscles response to electrical

impulses transmitted by nearby nerves. A slower or weaker response

suggests damage to the nerve or muscle

Nerve conduction studiesto check the flow of electrical current

through a nerve. Impulses that seem slower or weaker than usual

indicate possible damage to the nerve

ECGto check regularity of heart rate

Ultrasound - to check functioning of the bladder and other parts of the

urinary tract



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Treatment For Neuropathy

To reduce problems related to foot take special care of the

feet Follow the rules of foot care

To reduce muscle weakness

Physiotherapy and physical exercise may be advised

Insulin treatment is also reported to improve weakness

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To reduce GI symptomssuch as indigestion, bloating,

nausea and vomiting

Stop some types of anti diabetes medications

Small frequent meals, with low intake of fat and fibre

In severe cases medication may be prescribed

To reduce diarrhoea

Stop some types of anti diabetes medications

Suitable medication for diarrhoea is prescribed


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To reduce dizziness and weakness related to postural

hypotension

Sit or stand slowly from lying down position

Wear elastic stockings

Medication may be prescribed


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To reduce problems affecting the urinary tract

Drink more fluids

Pass urine regularly every 3-4 hours

Antibiotics to treat urinary infections

To reduce sexual problems

Counselling to help relieve stress

Medication to help improve impotence in men

Medication to reduce vaginal dryness and urinary tract infections in

women

Suction devices or Surgery for men


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It has now been proven that prevention of nerve damage- like

prevention of other long term complication of diabetes- is best

achieved through tight blood sugar control

Take Insulin, if advised

Strive to keep your blood sugar with in your target

< 120 mg/dl Fasting and < 180 mg/dl PP

You are in the best position to accomplish this goal through

regular blood sugar testing and appropriate adjustments in your

medication,diet and exercise

Conclus ion

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