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Diabetic Neuropathy

Paddy Kalish OD Blog Diabetic Neuropathy

Diabetes is a known cause of peripheral neuropathy. The condition typically begins to affect distal peripheral nerves in a relatively symmetric pattern. In addition to peripheral nerve involvement, the nerve damage caused by diabetes can also sometimes involve the autonomic nervous system, particularly as the condition advances or if it is not adequately treated. Smoking is not a fully established independent cause of neuropathy, but it can affect pain from diabetic neuropathy and may contribute to the severity of neuropathy.

Several factors can worsen diabetic neuropathy or exacerbate its symptoms, such as, Obesity, dyslipidemia, arterial Hypertension, and smoking have been shown to play an additional role in the development and symptoms of diabetic neuropathy.

The pathophysiology of peripheral neuropathy involves contributing factors of oxidative stress, the formation of advanced glycosylation end products, and microvasculature damage. The mechanisms by which smoking affects diabetic neuropathy may be related to oxidative stress and microvascular damage. Smoking is a known cause of oxidative damage. Diabetes and cigarette smoke are the main risk factors for the development of peripheral arterial disease.

Future Treatment modalities may include Gel-like protective lining of all blood vessels – Glycocalyx, being developed as medicine that can prevent Gel-like protective lining of all blood vessels – the glycocalyx – being developed as a drug that can prevent common complications of diabetes: diabetic retinopathy (DR) and diabetic kidney disease (DKD) and Diabetic Peripheral Neuropathy(DPN).

If you have Diabetes or if there is a positive family history, See your HCP and or Endocrinologist REGULARLY. DO NOT DELAY!!!

Glycated hemoglobin(normal, < 5.7%) 5.7%-6.4% indicates prediabetes; ≥ 6.5% or higher indicates diabetes).Results of electromyography (EMG) and nerve conduction velocity (NCV) studies are indicative of peripheral neuropathy of the hands and feet bilaterally.

 

Diabetic kidney disease, DKD, is diagnosed with blood and urine tests. The urine test looks for albumin, a blood protein that healthy kidneys don't filter out. The blood test measures how well the kidneys filter blood. Other tests include the albumin/creatinine ratio, which measures the amount of albumin in a urine sample compared to creatinine, and the glomerular filtration rate (GFR), which measures how quickly the kidneys filter blood.

Diabetic Retinopathy(DR) is diagnosed by Presence of

  • Swelling in the retina that could threaten vision
  • Evidence of poor blood vessel circulation in the retina
  • Abnormal blood vessels
  • New blood vessels or scar tissue on the retina
Author
Paddy Kalish OD, JD and B.Arch

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