diabetic neuropathy
Introduction
Introduction to diabetic neuropathy Diabetic neuropathy is a metabolic disorder of diabetes and peripheral and central nervous system damage caused by vascular disease, and its concomitant rate is estimated to be about 5% in the past. However, examination of electromyography, nerve conduction velocity and brain evoked potential found that the incidence of mild neurological changes can be as high as 92%-96% in the early stage. The lesions are mainly found in the peripheral nerves, the posterior roots, and also in the excitatory myeloid cord and muscle. basic knowledge Sickness ratio: 0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: cerebral thrombosis cerebral infarction dementia
Cause
Causes of diabetic neuropathy
The pathogenesis has not yet been fully elucidated, and it is thought that it is mainly related to metabolic disorders such as sugar, fat, and phospholipids caused by diabetes, arteriosclerosis due to nourishing blood vessels such as peripheral nerves, vascular disorders such as hypertrophy of the outer membrane, hyaline degeneration and even occlusion, resulting in nerves. Fibrous segmental demyelinating changes, axonal swelling and degeneration, fibrosis and end-plate tumors, etc., the lesions are mainly found in the peripheral nerves, the posterior roots, and can also be seen in the excitatory myelin and muscle.
Prevention
Diabetic neuropathy prevention
The true pathogenesis of diabetic neuropathy has not yet been fully elucidated. It is now believed to be mainly caused by diabetes, such as glucose, fat, phospholipids and other metabolic disorders, as well as arteriosclerosis due to peripheral nerves, nourishment of blood vessels, hypertrophy of the epithelium, hyaline degeneration, and even occlusion. Related to the disorder, resulting in segmental demyelinating changes in nerve fibers, axonal swelling and degeneration, fibrosis and end-plate tumors, etc. The lesions are mainly found in the peripheral nerves, the posterior roots of the spinal cord, and also in the excitatory myelin and muscles. The diagnosis and treatment of diabetic neuropathy focuses on early diagnosis and early treatment, which can reduce the onset and development of diabetic neuropathy.
Complication
Diabetic neuropathy complications Complications cerebral thrombosis cerebral infarction
The disease occurs as a complication of diabetes, which can be caused by diabetic angiopathy and cerebral thrombosis, especially multiple lacunar infarction and dementia.
Symptom
Symptoms of diabetic neuropathy Common symptoms Hypoglycemic coma, sensory disturbance, hypotension, wasting, hyperosmolar, coma, weakness, ocular nerve, paralysis, dementia, fatigue, ataxia
In addition to diabetes, such as polydipsia, polyphagia, polyuria, weight loss, fatigue, elevated blood sugar and diabetes, the nervous system can be expressed as:
First, peripheral neuropathy , the most common form of multiple neuritis, bilateral symmetric sensation, dyskinesia and ataxia, cranial nerve involvement is rare, may have one or both abductor nerve, oculomotor nerve Paralysis, retinitis and optic atrophy, plant gods can often be affected, manifested as gastrointestinal disorders, diarrhea, bladder disorders, impotence, orthostatic hypotension, abnormal sweating and unstable vasomotor function, myoelectric The picture shows a neurogenic change, and the nerve conduction velocity slows down.
Second, the symptoms of spinal cord injury , can be expressed as chronic poliomyelitis anterior horn cell damage, spinal cord sputum (called pseudo-neural spinal cord) posterior root, posterior column damage, and sub-acute spinal cord combined degeneration similar to the Lateral cord degeneration, these changes are thought to be caused by insufficient spinal blood supply caused by diabetic blood vessels.
Third, the symptoms of brain damage , diabetes causes brain disease for many reasons, may be due to high blood sugar, headache, weakness, physical strength and mental fatigue, excitement, emotional instability and other symptoms, long-term without proper treatment can cause memory loss, Depression, hyperosmolar coma, ketotoxic coma and hypoglycemic coma, in addition to diabetic angiopathy, and cerebral thrombosis, especially multiple lacunar infarction and dementia,
Fourth, muscle damage , can be expressed as pelvic girdle, scapular band and proximal limb muscle atrophy, diabetes with hypokalemia may have low potassium paralysis.
Examine
Examination of diabetic neuropathy
According to clinical manifestations, blood glucose, urine sugar, urine ketone body and other examinations, EMG, nerve conduction velocity measurement, etc. can be diagnosed.
Diagnosis
Diagnosis and diagnosis of diabetic neuropathy
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Identification of neuropathy caused by other causes.
Peripheral neuropathy may be a serious complication of HIV and is also thought to be associated with protease inhibitors and antiretroviral drugs similar to nucleosides.
