Diabetes mellitus is a rather dangerous disease, not only in itself, but also because of the likely complications that may appear in patients. One of them is diabetic polyneuropathy of the lower extremities. In this case, we are talking about pathology, during which damage to the nervous system of the human body occurs. Due to the fact that a person is surrounded by adverse environmental factors, the connection between some parts of the body and the brain is broken.
Patients have problems with coordination and performance of the lower extremities (the same thing can happen with the upper extremities). Facial muscles and more can be affected. In addition, against the background of diabetic polyneuropathy of the lower extremities, a complete violation of sensitivity may occur. To understand how to cope with this ailment, you should learn more about it. What are the varieties of pathology? What is the best way to treat her?
Diabetic polyneuropathy according to ICD-10
In this case, there are several subgroups of this pathology that have their own code:
- G61. If the pathology develops against the background of inflammatory processes that occur in the human body.
- G62. Refers to other varieties of polyneuropathy. This group includes several sections at once.
- G63 This is another big subgroup. Just in it you can find the necessary subsection. In this case, the ICD-10 code for diabetic polyneuropathy will be G63.2.
Thus, this pathology falls into a broader category of international classification. It is also worthwhile to understand in more detail the disease itself.
What is diabetic polyneuropathy
This disease is a pathology that damages immediately a number of certain nerve fibers, which are responsible for the motor functions of the foot, as well as their sensitivity. In this case, we are talking about an ailment of limbs.
The patient has severe pain and tactile sensations, and fever may occur. The beginning of the pathology is associated with the appearance of irritation of nerve fibers. After some time, they die. Against this background, in the lower extremities, on the feet, the cells responsible for the transmission of signals to the brain and spinal cord are completely destroyed. This leads to atrophy of the skin, as well as muscles.
Speaking about what is diabetic polyneuropathy, it is worth noting that in this case, the gait changes in patients and quite serious pain is manifested. Considering the signs that may affect this pathology, it is worth noting that they include:
- Too long development of diabetes mellitus (more than 5 years).
- Complicated capillaries in the kidneys or retina.
- Obesity.
Also, diabetic polyneuropathy of the extremities may appear with hypertension, coronary heart disease, or heredity. These reasons are recorded by doctors most often.
Classification
There are various forms of diabetic polyneuropathy. First of all, it is worth noting that the peripheral-type nervous system is divided into 2 zones. Based on this, experts classify this disease as:
- Somatic. In such a situation, the weakening of control on the part of the brain occurs, which can no longer be responsible for the proper functioning of internal organs.
- Standalone. In this case, the body completely loses its ability to influence the work of certain organs and systems.
At the same time, speaking about what is diabetic polyneuropathy, it is worth paying attention that with this pathology, damage can appear in different areas of the human body. Based on this, several types of this pathology are also distinguished:
- Sensory. In this case, a person completely or partially loses sensitivity when exposed to certain parts of his body. In these areas, temperature may increase. A person may not feel touch or other methods of exposure to the skin.
- Motor. In this case, patients have a serious motor function problem. It becomes more difficult for people to coordinate. Also, they often begin to make absolutely chaotic movements of the limbs.
- Sensorimotor. In this case, all the manifestations described above can be observed.
It is also worth paying attention to the fact that there is another classification of diabetic polyneuropathy of the limbs. In this case, the separation is based on the intensity of the manifestation of this pathology. Polyneuropathy happens:
- Sharp. This phase is the initial stage of the development of the disease. In this case, patients observe symptoms for the first time. Against this background, many of the first manifestations of the disease cause very strong fear. The fact is that the symptoms are quite intense and can cause serious discomfort.
- Chronic A similar phase occurs if the pathology developed over a long time without any treatment. In this case, the symptomatology becomes more smooth and does not bother the patients so much. This leads to the further development of pathology (due to the fact that a person simply decides that he does not need to seek help).
- Painless. Many, having seen the name of this phase, believe that in this case no symptoms appear. This is actually not the case. In such situations, patients suffer from numbness or loss of sensation in different areas of the body. And serious pain, in this case, is really not observed.
- Amiotrophic. According to doctors, this phase of the development of pathology is considered the worst, since it, in fact, is the last stage of the described ailment. In this case, patients complain of all the symptoms that were described in the previous stages.
Diabetic polyneuropathy (ICD-10 code - G63.2) requires immediate treatment, which may vary depending on the specific situation. It is very important to consult a specialist in a timely manner, who will analyze the symptoms and will be able to determine at what stage the disease is. Only then can we proceed to therapeutic measures. Treatment of diabetic polyneuropathy of the lower extremities is prescribed only by a doctor. Do not try to cope with this ailment on your own. So you can only do more harm yourself.
Symptomatology
In order to notice in time the appearance of this pathology, it is worth paying attention to the features of its development. Thanks to this, the development of more serious stages can be prevented.
Considering what is diabetic polyneuropathy, how it manifests itself, it is worth noting that, first of all, patients complain of burning, tingling, acute pain, lack of sensitivity after touching, heat. At the same time, a person can touch a warm object, which will seem to him too cold or, conversely, hot. Numbness in certain areas of the body, the appearance of so-called cramps and gait problems are also observed.
This symptomatology is considered the main. However, there are additional signs that are worth paying attention to. For example, you should be more careful if a person began to suffer from:
- Frequent dizziness.
- Visual impairment.
- Speech problems.
- Urinary incontinence and reproductive system problems.
In this case, you should immediately seek help and begin treatment of diabetic polyneuropathy of the lower extremities with drugs or other methods. It is also worth considering several varieties of the disease in more detail. They are most often found in medical practice.
Distal
In this case, we are talking about the process of death of nerve fibers in the human body. This means that after some time of the development of the disease, the patient begins to completely lose tactile sensitivity, which is most often localized in the lower extremities (or rather on the feet).
If a diabetic has this kind of pathology, then in this case he will complain of a dull aching pain, which sometimes becomes so strong that it is simply impossible to fall asleep or do usual things. Many begin to have very bad shoulders.
If distal diabetic polyneuropathy progresses, then this will lead to complete muscle atrophy, and the bones are deformed. Flat feet will develop. This can even lead to the need for amputation of the foot.
Peripheral
If we are talking about this kind of pathology, then in this case there are very serious problems of the sensorimotor function of the lower extremities. In some situations, unpleasant sensations in diabetics appear in the hands.
As a rule, the peripheral variety of this pathology often develops against the background of the fact that doctors decide to use strong antiviral drugs. They are known to have a huge amount of side effects. Therefore, when such symptoms appear, it is necessary to immediately abandon the course of treatment using a potent drug, choose a different course of therapy.
Dysmetabolic
This kind of pathology is characterized by additional diseases that appear together with diabetes. Patients begin to complain of problems with the stomach, intestines, kidneys and liver. Many nerve plexuses are also affected, which are located on the upper and lower extremities. Sciatic or femoral neurons are damaged. In this case, a person has severe pain in the affected area, trophic ulcers may develop.
Against the background of this form of pathology, it becomes very difficult for a person to move around. The tendon as well as the knee jerk disappears. Doctors often encounter situations where patients have damage to the ulnar, ocular, or trigeminal nerves.
However, it is worth noting that this form of the disease can also occur without any pain.
Reasons for the development of pathology
If we talk about the main signs that affect the appearance of diabetic polyneuropathy of the lower extremities, then in this case, of course, we are talking primarily about too high blood sugar and situations when a person experiences a long insulin deficiency.
Also, this pathology can form against the background of:
- Endocrine disorders.
- Severe kidney and liver disease.
- Depression
- Weakened immunity.
- Various infections.
- Alcohol problems.
- Poisoning.
Also, a person may develop this pathology if he suffers from atherosclerosis, nephropathy, retinopathy, arterial hypertension, vitamin deficiency, and obesity. Not the best effect is smoking. It is also worth being careful of older people, as in this case the chances of developing pathology are much higher.
Diagnostics
First of all, it is necessary to list to the doctor all the symptoms from which the patient suffers. It is important to clarify the time of their manifestation and duration. It is also necessary to talk about the development of diabetes and provide all the necessary data. They will help to more clearly present the clinical picture.
Also, a specialist must check the lower extremities. He pays attention to tendon reflexes, refines muscle strength, as well as tone. In addition, attention should be paid to the sensitivity of the skin in the area of the feet.
If we talk about laboratory studies, it is necessary to take blood tests, according to the results of which the doctor will be able to determine the amount of the patient's own insulin and the level of beta cells of the pancreas. Additionally, you need to know the indicators of cholesterol and lipoproteins. Typically, with polyneuropathy, these indicators increase significantly. Of course, glucose is checked. It is necessary to clarify the degree of diabetes from which the patient suffers.
Also, the patient can be referred to a gastroenterologist, endocrinologist, ophthalmologist and urologist. Thanks to additional research methods, you can get a clearer picture. For example, a magnetic resonance imaging scan may be performed. Thanks to this, you can get more accurate information about the foci of pathology.
Other procedures are underway. For example, an echocardiogram and ultrasound of the heart. In this case, you can evaluate how well the cardiovascular system works and whether there are additional pathological processes that occur in the human body. In addition, a specialist can conduct a biopsy of the calf nerve. However, such studies are performed only in the most urgent cases, when the doctor doubts the diagnosis and the appointment of the necessary treatment for diabetic polyneuropathy.
Therapy
Most often, doctors diagnose a distal form of the disease. In this case, the treatment may be:
- Pathogenetic. It is necessary to restore the proper functioning of damaged nerve fibers.
- Symptomatic. Unpleasant manifestations of the disease are muffled.
Regardless of the selected type of treatment for diabetic polyneuropathy, it is impossible to completely eliminate the root cause of the development of pathology. Therefore, doctors are taking measures that help slow down the progression of the disease. Thanks to this, it is possible to minimize the likelihood of developing complications. This helps a person to return to normal life.
Treatment of pathology with these methods is considered conservative. It implies application
- Drug therapy.
- Physiotherapy and exercise therapy.
- Diet therapy.
- Herbal medicine.
Also, the doctor may prescribe a comprehensive treatment. In this case, it is possible to achieve the greatest efficiency and the best results. However, self-medication is not worth it. Especially when it comes to the use of drugs. Treatment for diabetic polyneuropathy should only be prescribed by a doctor. This is because in some cases, funds are used that need to be taken very carefully, to correctly calculate the dosage based on the specific parameters of the patient.
Drug treatment
To quickly restore the functioning of nerve fibers and help restore their conduction, doctors most often prescribe funds in the form of vitamin complexes. As a rule, group B refers to them. Also, a specialist can prescribe alpha-lipoic acid.
It is worth noting that with pathogenetic treatment, a quick result should not be expected. The course of treatment is often quite long, so you need to be patient.
However, sometimes patients are tormented by such severe pains that they cannot fall asleep and engage in familiar activities. Many begin to develop increased anxiety and depression. To save the patient from unpleasant sensations, the doctor can prescribe antidepressants, anticonvulsant drugs, as well as painkillers.
Many decide to start taking Ibuprofen on their own. However, it must be borne in mind that you can use this non-steroidal anti-inflammatory drug only in extremely short courses. Otherwise, there is a risk of damage to the gastric mucosa.
Additional treatments
The doctor may also recommend taking a course of physiotherapy, massage or physiotherapy exercises. Such events help to get rid of the pain syndrome. Improving nutrition of nerve tissue. Thanks to this, the appearance of atrophy can be avoided.
Massage is allowed to perform, both standard and acupuncture. Choosing the second option, you need to contact a specialist. Do not practice acupuncture at home.
A positive result is given by diet. In the patient's diet should be as much food as possible, rich in useful trace elements and vitamins. Experts recommend eating lentils, nuts, seeds, beans, tomatoes, parsley, peas, bran, seafood.