Neuropathy Diabeticus (NPD) is a chronic disease characterized by abnormal nerve conduction through the nerves. Nerve conduction abnormalities are present in up to 30% of patients with diabetes mellitus.1,2 There are two types of diabetic neuropathies: primary and secondary. Primary type affects mainly the peripheral nervous system (PNS). Secondary type affects mostly the central nervous system (CNS), but it may affect other organs such as heart or liver.3,4
Primary neuropathy occurs when there is damage to the myelin sheath around the axons of neurons. Myelination protects the neuron from injury by insulating it against electrical current. Damage to myelin causes neuronal death resulting in loss of function and eventually paralysis.5,6,7,8,9
Secondary neuropathy occurs due to damage to neurons themselves. Damage to neurons results in a decrease in their ability to transmit signals, which leads to weakness and fatigue.10,11
Diabetes is associated with increased risk of developing neuropathy.12,13 The prevalence rate of NPD among individuals with diabetes ranges between 0.5% and 1%.14,15,16 NPD is one of the most common long-lasting complications of diabetes and is the most common cause of sensorimotor peripheral neuropathy.17
Diabetic foot ulcers are one of the most serious complications of diabetic peripheral neuropathy (DPN). Foot ulceration is a severe complication of DPN and the leading cause of non-traumatic amputations in patients with diabetes mellitus (DM). It is an important risk factor for the development of diabetic macrovascular complications.
Foot ulcers develop in up to 19% of patients with DPN at least once during their lifetime, and in 2-3% of them this condition leads to death.18,19,20
DIABETIC FOOT ULCERATION
Upper limb peripheral diabetic neuropathy usually causes a loss of vibration and position sense but not muscle strength unless it is very severe. On the other hand, lower limb peripheral diabetic neuropathy can also cause muscle weakness and exercise intolerance. The causes of these symptoms are not completely understood but are likely to be due to changes in both the nerves and the muscles.
Diabetic neuropathic foot ulceration can be classed as either superficial or deep. Superficial ulcers affect the toes or top of the foot, often caused by friction from footwear. These are more common in men who smoke and are often associated with acute disturbances in blood glucose levels, such as following a poor diet.
They normally heal well with local care and possibly minor surgery.
Deep ulcers affect the heel, arches of the feet and the ball of the foot. They often occur without any obvious cause but may follow a superficial ulcer and result in more serious complications such as osteomyelitis, a bone infection. It is very important to identify these early to ensure successful treatment to prevent the need for further surgery that may involve removing part of the foot.
HOW CAN NPD BE TREATED?
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Beneficios del aceite de onagra by AM Moreno – farmaciaribera.es
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