Diabetic Neuropathy

Diabetic Neuropathy is a nerve disorder caused by acute diabetes. Those suffering from diabetes for more than 20 years are more likely to suffer diabetes neuropathy. Abnormal blood fat levels along with long durations of diabetes are the usual cause of diabetic neuropathy. This condition manifests as weakness and numbness in the limbs. It can also affect the heart, digestive tract and genitals. Peripheral neuropathy is the most common manifestation of diabetic neuropathy wherein the limbs of the patient are affected. Autonomic neuropathy affects digestion, bowel and bladder function, sexual response and perspiration. There might be adverse effects on the heart and blood pressure. Focal neuropathy affects a single nerve in the wrist, thigh or foot. It can also affect the nerves controlling the eye muscles. Smoking and excessive consumption of alcohol may further increase the risk of diabetic neuropathy.

Patients suffering from promimal neuropathy experience pain the hips and thighs and weakness in the legs. Symptoms of diabetic neuropathy include numbness and tingling in the feet, legs and arms. There may be dizziness due to drop in postural blood pressure. Diarrhea, constipation and indigestion are common symptoms of diabetic neuropathy. Patients suffering from diabetic neuropathy may have erectile dysfunction or vaginal dryness. Treatment for diabetic neuropahty has to be individualized. Acupuncture or medications can relieve pain in the case of peripheral neuropathy. Persons suffering from diabetes must monitor blood sugar levels. Any foot problems must be attended to promptly.

Diabetic Retinopathy

Diabetic Retinopathy is a common complication with Diabetes where the production or use of insulin levels are not regulated resulting in fluctuating blood sugar levels. Diabetic Retinopathy results in 90% of the cases of type 1 Diabetes and 65% of the cases of type 2 diabetes. Retinopathy is the damage or hemorrhaging of small blood vessels of the retina. It is a non-inflammatory disease of the retina. There are many types of retinopathy. Non Proliferative Retinopathy refers to the condition where the damaged or leaking vessels do not spread. Symptoms include vision spots, loss of vision in some cases, floaters - floating regions of blurred vision or loss of fine vision. On the other hand, Proliferative Retinopathy refers to the spread of the damaged retina - specifically the rupture of the newly formed blood vessels resulting in sudden loss of vision.

Hardening of the retinal arteries is known as Arteriosclerotic Retinopathy. Increased pressure in the affected region may result in the retina detaching itself from the back of the eye that can cause partial or total blindness.

Hypertensive Retinopathy: Hypertension can cause damage to the blood vessels of retina resulting in Hypertensive Retinopathy which has symptoms that include blurred vision or decreased visual perception.

Risk Factors for Retinopathy

• Diabetes mellitus
  
• Hypertension
  
• Hypercoagulability (abnormal tendency of the blood to clot - thrombosis), Thrombophilia
  
• Hyperlipidemia (Abnormally high blood lipid levels)
  
• Hyperviscosity
  
• Trauma
  

Diagnosis and Treatment

Retinal Specialists may use ophthalmoscope or Fluorescein Angiography for a detailed evaluation of the eye condition. Laser Surgery is usually the first choice of treatment to seal the bleeding blood vessels in the retina (retinal hemorrhages). Treatment of diabetic retinopathy would also involve treating the overall condition. Nutritional supplements like Vitamins A, C, E and Lutein may also be tried.

Diabetic coma

A kind of reversible coma that is noticed with patients suffering from diabetes, diabetic coma is a medical emergency. Diabetics who are taking insulin can sometimes lapse into a condition of hypoglycemia where they fall unconscious. It may be preceded by rapid heart beat, sweating and convulsions. This condition is treated immediately with intravenous glucose. Diabetic ketoacidosis occurs at a more advanced stage, when the patient is severely dehydrated and in a state of shock. After nearly a couple of days of hyperventilation and shock, diabetic coma might result. Nonketotic coma is a condition where extreme hyperglycemia causes dehydration due to inadequate fluid intake. The patient is given intravenous fluids, potassium, sodium and insulin.