An old patient with diabetes told Huazi that he felt his hands and feet numb, so he went to the hospital for examination. The doctor said that diabetes caused peripheral neuropathy. What disease is this? How to treat it in the future?
Huazi said that if people with diabetes are not well controlled, it may cause peripheral nerve damage to , especially for people with long-term illness. Half of diabetics who have been suffering from diabetes for more than 10 years will develop peripheral neuropathy, but the mechanism of disease formation is not yet clear, so treatment should also start from multiple aspects.
1. Diabetes can cause peripheral neuropathy
Now people have not figured out the exact mechanism of diabetes causing peripheral neuropathy, but one thing is certain, that is, is related to long-term severe hyperglycemia . This leads to various reactions such as microvascular lesions, DNA damage, oxidative stress damage, neuroinflammation, and cell nutrition disorders, which ultimately lead to irreversible damage to nerve cells.
The typical symptoms of peripheral neuropathy are the occurrence of various sensory abnormalities such as burning, acupuncture, ant walking, numbness, pain and other sensory abnormalities at the distal end of the limbs. At the same time, it may also involve multiple systems such as cardiovascular, digestion, urogenital, etc., resulting in various symptoms such as rapid or slow heart rate, abnormal blood pressure, , regulation, indigestion, abnormal urination, and sexual dysfunction.
However, There is no specific diagnosis method for this disease . Diabetic patients with the above symptoms may consider diabetic peripheral neuropathy after eliminating other factors such as vascular inflammation, spinal disease, renal insufficiency, thyroid disease , infectious diseases, adverse drug reactions, etc.
2. Controlling blood sugar is the key to treatment
Among the possible mechanisms of diabetes causing peripheral neuropathy, the most important one is "sorbitol accumulation hypothesis" . There are two main ways for the normal metabolism of blood sugar (glucose) in the human body. One is to perform aerobic metabolism of , which will eventually produce water and carbon dicarbonate; the other is to perform anaerobic metabolism of to produce lactic acid.
However, when blood sugar is too high, the main metabolic pathway cannot use all glucose , which will increase the bypass metabolism of glucose, causing glucose to generate sorbitol under the action of aldose reductase. A large amount of sorbitol accumulates, which can cause peripheral nerve damage.
So, hyperglycemia is the direct cause of the disease. The key to treatment is to control blood sugar . Generally speaking, controlling glycated hemoglobin (HbA1c) within 7% can better prevent peripheral neuropathy.
3. Drug treatment should start from multiple aspects
The mechanism of peripheral neuropathy of diabetes is inaccurate, and there may be multiple risk factors, so drug treatment should also start from multiple aspects.
1. Improve metabolic disorders : You can use epastat , an aldose reductase inhibitor, which can prevent glucose from being metabolized bypassed and reduce the production and accumulation of sorbitol.
2. Antioxidant stress : You can use lipoic acid , which is a B vitamin, which has strong antioxidant effects, can reduce lipid oxidation of neural tissue , inhibit protein glycosylation, and also inhibit aldose reductase.
3, improve microcirculation : Pancreatic kininoprolase can be used, which can dilate blood vessels, improve microcirculation disorders, and increase nutrition and oxygen supply to neural tissues.
4. Promote neural repair : Methylcobalamin can be used to promote nucleic acid metabolism and protein synthesis of nerve cells, and promote the transportation function and regeneration of axons.
5. Relieve pain symptoms : The main symptom of peripheral neuropathy is pain, which will seriously affect the quality of life and require pain relief treatment. Antidepressants, antineurotic drugs, and central analgesic drugs can all be used for pain relief treatment for diabetic peripheral neuropathy. Specific drug selection needs to be carried out under the guidance of a doctor.
Summary: Diabetics have poor blood sugar control for a long time and are prone to peripheral neuropathy. Hyperglycemia is the main cause of the disease, and controlling blood sugar is the key to treatment.However, the mechanism of the disease is not clear now. Drug treatment needs to start from many aspects. The selection and use of specific drugs need to be carried out under the guidance of a doctor. If you have any questions about medication, please consult your doctor and pharmacist. I am Huazi, pharmacist. Welcome to follow me and share more health knowledge.
