Diabetes is a great damage to the nervous system, it can be said that neuropathy is one of the highest incidence of chronic complications of
Diabetes is a great damage to the nervous system, it can be said that neuropathy is one of the highest incidence of chronic complications of diabetes, the incidence of diabetic neuropathy in China was 60.3%. Glucose into nerve cells without the help of insulin in patients with diabetes, so intracellular glucose concentration is often high, the glucose in the catalytic activity of aldose reductase, the first generation of sorbitol, and then converted to fructose, the osmotic pressure rise high in nerve cells. At the same time as the patient of high blood sugar, glycosylated protein degeneration of nerve cells, coupled with diabetic microangiopathy caused by local hypoxia, resulting in swelling of nerve cells, nerve fibers of tunica vaginalis shedding, diabetic neuropathy. All parts of the nerve tissue may be damaged by diabetes, according to its location and function, can be divided into two types of diabetic neuropathy and peripheral neuropathy. The central nervous system including the brain and spinal cord, in front of about the relationship between diabetes mellitus and cerebrovascular disease have been mentioned, diabetes can also affect the spinal cord, manifested as limb sensory and motor disorders, position sense disappeared, may also have difficulty in urination and impotence. Diabetic peripheral neuropathy includes cranial nerve, sensory nerve, motor nerve and autonomic neuropathy. There are 12 pairs of cranial nerves, affecting most affected by diabetes, cranial nerve injured included upper eyelid lift, eye movement disorders, see double shadow, hearing loss, Kouyanwaixie; diabetic sensory neuropathy is common, mainly for peripheral neuritis, often bring great suffering to patients. Peripheral neuritis symptoms of pain and numbness, pain serious when some patients will lose the courage to continue to live. The patient can have abnormal feeling, such as burning feeling, ant walking feeling, tactile allergies, but the real high temperature, low cold or stab and other external stimuli but not normal feeling, can not immediately take self-protection measures. And the patient stated "no root" feet ", like stepping on cotton as" easy to fall; compared with the sensory nerve, motor nerve involvement is relatively rare, mainly for vascular nerve lesions, such as weakness, muscle atrophy, limb pain, occasionally simple paralysis caused by limb paralysis, most patients after treatment, the symptoms can disappear; diabetic autonomic neuropathy is very rare, the patient often complain profusely, especially the head and torso, limbs can not sweat, when a meal or a little activity will be sweating, and the patient showed the body sweating. Abdominal distension, bowel disorders, diarrhea and constipation are not uncommon. Patients with orthostatic hypotension, they often lie high blood pressure, stand up, blood pressure drops, and even dizziness fall. In addition to many patients with urination disorders, or pee does not come out, or urine dripping wet. Diabetic impotence, infertility is also very common. These symptoms are associated with diabetic neuropathy.
The pathogenesis of diabetic neuropathy rate is very high, unfortunately in the treatment, especially the cure of diabetic neuropathy is quite difficult, so the prevention and treatment of diabetes by the most important disease or prevent it from happening, development and its control. The first is to control diabetes, in order to delay the progress of diabetic neuropathy. Diabetes control is good or bad, sometimes not and the rate of progress of diabetic neuropathy in parallel, due to different genetic characteristics, good control of patients with neuropathy is not necessarily worse than the control light, that is to say people can't than. But for each patient, good control of diabetes, it is beneficial for the prevention and treatment of diabetic neuropathy; second is the use of large doses of vitamins, such as vitamin C and vitamin B family, E methyl B12 (Methycobal) might help in recent years have been advocated to improve neural phospholipid metabolism with aldose reductase inhibitor or gangliosides drugs, reduce sorbitol production, improve nerve conduction velocity, how to solve the problem of diabetic neuropathy, fundamentally, of course, remains to be seen; third is the use of vasoactive substances to improve microcirculation, because some people think that neural stem on microvascular disease is caused by one of the pathological basis of diabetic neuropathy. In this regard, the Chinese medicine may play a greater role; fourth symptomatic treatment, in order to minimize the pain caused by diabetic neuropathy patients. Symptomatic treatment, including relief of pain, reduce numbness, avoid orthostatic hypotension, adjust the size of the stool, the treatment of impotence, etc., these problems should be mentioned in the medical treatment chapter.