What is the Best Treatment for Neuropathy

Diabetic neuropathy is the common complication of diabetes and is due to poorly controlled blood sugar and chemical changes that occur in the nerves.

There is no single best treatment available to prevent or manage neuropathic changes. Neuropathic treatments are usually based on three major criteria: intensive blood sugar control and risk factor management, symptomatic pain management and treatments based on the disease process.

Stromal vascular fraction is a newer form of stem cell therapy that has been studied and found to offer an effective modern treatment option for patients with diabetic neuropathy. Stromal vascular fraction is rich in mesenchymal stem cells, which has the potential to repair damage nerve tissues and also lower blood glucose level.

Pain-relieving medications may include anti-epileptic drugs and antidepressants. For anti-seizure medications, the American Diabetes Association recommends pregabalin (Lyrica), gabapentin (Gralise, Neurontin) and carbamazepine (Tegretol, Carbatrol).

For antidepressants, two classes are recommended namely, tricyclics and Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Can Diabetics Get Pedicures?

People with diabetes need to be extremely careful when getting a pedicure, as they are at risk of infections, most especially if blood glucose is not well controlled or presence of hand or foot complications such as poor blood circulation, open sores, and peripheral nerve damage. Poor blood circulation can lead to poor wound healing and inability of the feet to fight any infection. Also, peripheral nerve damage can cause loss of sensation, making it less likely for you to notice any cut, bruises or injury to the foot.

If you are diagnosed with diabetes, it is highly recommended you follow these precautions before getting a pedicure.

  • Always go to a salon that is neat and tidy, uses sterile instruments and has technicians who are very meticulous.
  • Ensure all tools that will be used are thoroughly washed and sanitized with disinfectants or a surgical
  • If possible, buy your own nail kit.
  • Avoid a pedicure session if you currently have any open sores on your legs, feet or toenails or infections.

What is The Main Cause of Type 2 diabetes

Type 2 diabetes is the most common form of diabetes and usually affects people above the age of 30. Unlike type 1 diabetes that begins during childhood, type 2 begins in early adulthood. Type 2 diabetes is believed to be caused an interplay of genetic and environmental factors. The most overwhelming of these factors are overweight or obesity, lack of physical activity and a family history of type 2 diabetes.

What are The Early Signs of Diabetes

Early signs of diabetes, also known in some medical literature as warning signs are usually hard to recognize, even if they occur at all. A survey carried out by the Centre for Disease Control (CDC) estimates that 1 in 4 adults living with diabetes are unaware that they have this condition. As a result, many people tend to develop early complications from diabetes. Early signs and symptoms of diabetes include

  • Polyuria (Frequent urination): When there is excess sugar in the blood, the kidney tries to get rid of the excess sugar by filtering it out from the blood and into the urine. Because of the osmotic effect of sugar to draw more water to itself, this results in more urine production and the need to urinate more frequently.
  • Increased thirst or a dry mouth: Frequent urination causes the body to lose a lot of fluid. Consequently, can result in dehydration and the need to drink more water
  • Feeling hungry all the time: Due to excessive loss of glucose through the urine and inability of the body to effectively convert glucose to energy, people with diabetes are in a constant state of energy deficit. This energy deficit sends signals to your brain that your body is hungry, regardless of how recently you have eaten, causing you to eat more and more food.
  • Feeling very weak and tired: Unusual body weakness and fatigue is also an early sign of diabetes. This is due to the low energy levels caused by insufficient glucose moving into the body’s cells.
  • Frequent, recurrent yeast and bacteria infection: Sugar is a good medium for the growth of both yeast and bacteria, especially when the sugar is not well controlled. Women are at high risk of developing sexual and reproductive health issues such as vaginal thrush and bacterial infections. For both men and women, yeast infections can also infect warm and moist areas of the skin, such as the groin, armpit, and underneath the breast in women. Skin infection from bacteria microbes is also very common. Common skin infections include folliculitis, carbuncle
  • Patches of skin hyperpigmentation: This skin condition is known as acanthosis nigricans

What are the Complications of High Blood Sugar

Complications of diabetes can be divided into short-term and long-term complications. Short term or acute complications include

  • Diabetic ketoacidosis: Diabetic ketoacidosis is a medical emergency in which high blood glucose is associated with metabolic acidosis due to increase level of blood ketones. It occurs mainly, but not exclusively in type 1 diabetic patients. It is can also be seen in type 2 patients. Precipitating factors/triggers for diabetic ketoacidosis include infections (sepsis, pneumonia, urinary tract infection), pregnancy, inadequate insulin administration, excess alcohol ingestion, pulmonary embolism, stroke, myocardial infection, new onset of type 1 diabetes, drugs (anti-epileptic drugs, glucagon, corticosteroids, cocaine)
  • Hypoglycemia: Hypoglycaemia is an important and life-threatening complication of diabetes. Cause of hypoglycemia is either taking too much insulin or drugs that increase insulin levels in the blood or skipping meals or not enough glucose in the blood. If hypoglycemia is not treated or corrected on time, it can lead to loss of consciousness,
  • Lactic acidosis: Lactic acidosis is a rare complication seen in diabetic patients. It occurs when the body

Signs and symptoms of lactic acidosis may include nausea, vomiting, abdominal pain, altered mental status, low blood pressure, shock reduced urinary output, low body temperature, hallucination or coma.

  • Hyperosmolar hyperglycemic state.

Long-term or chronic complications of diabetes glaucoma, periodontal diseases, cataract, infections (malignant otitis externa, rhinocerebral mucormycosis, emphysematous pyelonephritis), dermatological (Diabetic bullae, Necrobiosis lipoidica, lipodystrophy, xanthoma), peripheral neuropathy, diabetic retinopathy

 

 

References

Casparie, A., & Elving, L. (1985). Severe Hypoglycemia in Diabetic Patients: Frequency, Causes, Prevention. Diabetes Care8(2), 141-145. doi: 10.2337/diacare.8.2.141

Cryer, P. (1995). Diabetes, Diabetes, and the American Diabetes Association. Diabetes44(12), 1351-1354. doi: 10.2337/diab.44.12.1351

Factors in the development of diabetic neuropathy. Baseline analysis of neuropathy in the feasibility phase of Diabetes Control and Complications Trial (DCCT). The DCCT Research Group. (1988). Diabetes37(4), 476-481. doi: 10.2337/diabetes.37.4.476

Tao, L., MacKenzie, C., & Charlson, M. (2008). Predictors of postoperative complications in the patient with diabetes mellitus. Journal Of Diabetes And Its Complications22(1), 24-28. doi: 10.1016/j.jdiacomp.2007.05.008