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.

Ulnar Neuropathy

Ulnar nerve is a nerve that originates in the brachial plexus and travels downwards to the arm. It extends from shoulder to the wrist and branches into little finger and ring finger. It is responsible for sending sensation to the inner forearm, a portion of the palm near the little finger and half of the ring finger. Any damage caused to this nerve leads to a condition called ulnar neuropathy.

One of the most common causes of repeated neuropathy is compression. This is the only nerve in the entire body that is not well protected by bones and muscles and hence more prone to damage. The ulnar nerve can be constricted and get entrapped as it passes through the elbow and wrist. It can even be entrapped under the collarbone or at the point of origination near spinal cord. However, the ulnar nerve is commonly entrapped at the elbow and the condition is known as Cubital Tunnel Syndrome. It is also referred to as ulnar nerve compression, Ulnar nerve palsy or ulnar nerve entrapment. The other names for ulnar nerve condition are Bicycler's neuropathy and Guyon's canal syndrome.

Patients with ulnar nerve compression at any level have altered sensation in the little and ring fingers. Indeed, in most patients, sensory loss is the first symptom to be reported. As the condition progresses, they may also notice clumsiness in the hand, as the ulnar nerve is the principal motor supply to the intrinsic muscles of the hand. In well‐established cases, there may be marked wasting of the small muscles of the hand and the ulnar‐sided muscles of the forearm. Typical symptoms of this condition involve numbness and reduced sensation in the fingers. Clumsiness or weakness of the hands might be noticed. There is loss of grip and reduced coordination between fingers.

Direct injury to the nerve or pressure are primary causes for this condition. In severe cases of ulnar nerve compression, wasting of the muscles of the hand and forearm may be detected. Any injury such as fracture, dislocation or severe twisting of elbow can affect the the ulnar nerve. Pressure on the nerve caused by swelling or injury of adjacent tissue can also lead to ulnar nerve compression.

A through physical examination is conducted and history and symptoms of the patient are noted. Doctor may ask the patient to perform certain tasks with the hands to understand if the pain is arising due to ulnar nerve entrapment. Ultrasonography and/or MRI of the ulnar nerve in conjunction with nerve conduction study to assess the functioning of the ulnar nerve, can help identify the location at which it is being compressed.

Treatment of Ulnar Nerve Compression

Ulnar neuropathy is most often treatable through a conservative approach. Pain relievers and anti-inflammatory drugs are prescribed to address the pain. Steroid injections, though highly effective, are avoided as they can damage the nerve when injected in that region.

• Giving some rest to the elbow and keeping it straight relieves the pain. Doctor may prescribe a padded brace or splint to wear at night to keep the elbow straight while sleeping.
  
• Occupational therapy is also found to be highly effective in treating ulnar neuropathy as it strengthens the ligaments and tendons surrounding the elbow region and wrist.
  
• Nerve gliding exercises are also taught to release the trapped ulnar nerve through cubital tunnel at the elbow or the Guyon's canal at the wrist.
  
• When physical therapy and other forms of non-surgical treatment fail to address the pain and when the arm muscle is getting wasted, nerve entrapment surgery is the only option to treat ulnar neuropathy.

Diabetes Mellitus Type 1

Diabetes mellitus is characterized by high blood sugar. Referred to as diabetes, this disease affects millions worldwide. Left untreated, diabetes can lead to blindness, diabetic neuropathy and kidney failure. Diabetes is most often a chronic medical condition that needs constant monitoring and control. Diabetes can be of 2 types - Type 1 and diabetes type 2. Type 1 diabetes is called juvenile-onset diabetes or insulin-dependent diabetes. Complications that can arise with Type 1 diabetes are hypoglycemia and hyperglycemia. Left untreated, it can lead to ketoacidosis.

Often this type of diabetes is inherited. Diabetes mellitus type 1 is seen in children and young adults. A person suffering from diabetes type 1 is insulin dependent. Diabetes mellitus type 1 is characterized by insufficient production of insulin by the pancreas. This can occur due to an auto immune condition or it can also be idiopathic in nature. Insulin is critical to the absorption of sugar by the body. As a result, blood and urine levels of sugar rise. Type 1 diabetes also affects fat metabolism. While most cases of type 1 diabetes have a genetic predisposition, certain environmental factors trigger it off.

Symptoms of diabetes type 1 are excessive thirst and urination. Other symptoms include blurred vision, dramatic weight loss, irritability, weakness and fatigue. Diabetes mellitus type 1 leads to excessive hunger. Girls may notice vaginal yeast infection. A doctor may prescribe changes in eating habits and maintenance of body weight. Regular exercise regimen is suggested to keep diabetes under check. Daily dose of insulin is needed for persons who suffer type 1 diabetes. Persons suffering from this form of diabetes are advised to monitor blood levels of sugar as well as urine levels of ketone.