Diabetic encephalopathy is a lesion of certain structures in the brain. This occurs as a result of metabolic and vascular disorders that occur and develop with a disease such as diabetes.
This ailment is not an independent pathology, since it can develop only as a result of existing violations in the functioning of the body.
Who gets sick more often?
According to statistical studies, type I diabetics are most often affected by this disease. Moreover, depending on the statistical sample, the frequency of this disease can reach 80%.
A feature of DE is the complexity of its differentiation with other types of encephalopathy.
Causes
Diabetic encephalopathy can develop for several fundamental reasons:
- Microangiopathy. It is a process in which a violation develops in the stability of the walls and the permeability of the vessels of small arteries, as well as capillaries.
- Metabolic disorders leading to damage in nerve fibers and cells.
Pathological causes
In addition to the main reasons due to which the disease develops, there are also pathological factors that exacerbate diabetes mellitus and lead to the development of DE. These include:
- Patient's age (senile and elderly).
- The presence of obesity, entailing excess body weight.
- Violation of lipid metabolism, as well as atherosclerotic manifestations.
- Persistent increased blood glucose.
The main damaging factor
But still, in the formation of diabetic encephalopathy (ICD 10), microangiopathy is the main damaging factor. As a result, nerve fibers and cells undergo oxygen and energy starvation. Due to such starvation, the body is forced to switch to the path of anaerobic production of vital substances for its functioning. This process is not so effective and as a result, toxins and other harmful substances accumulate in the brain cells. It is under their influence that irreversible brain damage occurs.
Existing metabolic disorders in the body exacerbate the condition that has arisen, and also catalyze the restructuring of nerve fibers. Which, in turn, contributes to the process of slowing down the transmission of nerve impulses.
Clinical manifestations
The clinical manifestations of diabetic encephalopathy (ICD 10) require a long time for their development. For this reason, DE is most often diagnosed in senile patients. In rare cases, encephalopathy can be rapidly developed against the background of a brain stroke or in acute conditions of a hypo- or hyperglycemic nature.
Symptoms
Unfortunately, diabetic encephalopathy is not accompanied by any specific symptoms, which complicates its diagnosis and differentiation. This type of encephalopathy may be accompanied by symptoms that are also characteristic of atherosclerosis or hypertension.
A patient who is suspected of having DE may suffer from symptoms such as:
- Headaches - can have different severity and manifest as a slight malaise, and in the form of feelings of fullness or squeezing.
- Asthenic syndrome can be expressed in the form of weakness, irritability, impaired concentration of attention, as well as mental lability and increased emotionality.
- Manifestations of a neurological nature - the patient may have an uncertain gait, feel a feeling of dizziness and noise in the ears.
- Disturbances in the functioning of higher brain functions. The patient may have impaired memory and fine motor skills, difficulty in perceiving information, loss of reading ability, manifestation of depression and apathy.
- Another symptom of diabetic encephalopathy is syncope and convulsive syndrome. Moreover, convulsions can occur both localized and generalized.
As a rule, the patient is not always able to adequately assess his condition, so the use of a serious diagnostic search, as well as the help of relatives and friends, will not be out of place.
Manifestations of DE
At the initial stage of the disease, its symptoms are poorly expressed. Therefore, often the patient finds it difficult to answer when the first symptoms appear.
The primary manifestations of diabetic encephalopathy are experts consider subtle memory impairment, problems falling asleep, as well as changes in the psycho-emotional status.
These violations can be explained by the fact that the brain has to work in conditions of lack of energy and oxygen. Under such conditions, nerve cells are not able to work fully and compensatory mechanisms begin to arise. However, if these mechanisms are used for a long time, they fail, which leads to the accumulation of toxins in the brain.
Stages of development of encephalopathy in diabetics
The disease has several stages, while the patient does not feel any symptoms in the first stage. Only when the disease develops and passes to the second stage, the first signs appear:
- At the first stage. Manifestations are practically absent. Unstable blood pressure, the occurrence of mild malaise, dizziness, often the symptoms are confused with the manifestation of vegetative-vascular dystonia. A neurologist is the most visited specialist at this stage.
- In the second stage. The head begins to hurt more, the orientation is disturbed, the neurological status becomes more pronounced.
- In the third stage, the symptoms are pronounced. Cerebral circulation worsens significantly. Headache, gait shakiness, dizziness, general weakness, insomnia. There is often a pre-syncope state.
Syndromes of the disease in question
Diabetic encephalopathy in the ICD with code 10 is manifested in the form of several syndromes, which can be called the main ones:
- Asthenic syndrome. It is characterized by a state of general weakness, lethargy and rapid fatigue. Often this syndrome is one of the first. Also, the patient with asthenic syndrome experiences disability, can be overly irritable and emotionally unstable.
- Cephalgic syndrome. DE may be accompanied by a headache of varying intensity. If you rely on the descriptions of the patients themselves, then for some it can manifest itself in the form of squeezing or squeezing like a “ring”, for others it is similar to migraine sensations, for others it manifests itself as a feeling of heaviness in the head. Some patients generally note that the headache is quite mild.
- Vegetative dystonia. This syndrome occurs in the vast majority of cases of manifestations of DE. Dystonia manifests itself in the form of an emerging feeling of heat, fainting, and a fainting state. In addition, autonomic dystonia can be characterized by such disorders as anisocoria (when the patient's pupils are of different sizes), convergent disorders (difficulty in moving the eyeballs), pyramidal disorders (for example, paralysis). The patient may also suffer from vestibular-ataxic symptoms, such as, for example, hesitant gait or dizziness.
- Cognitive impairment. This syndrome of diabetic encephalopathy with code 10 is characterized by impaired memory, general inhibition, inability to absorb information. May contribute to the development of depressive and lethargic conditions.
- The final stage. This stage of the disease can be characterized by severe disorders of all parts of the nervous system. The patient has a violation of motor activity, there are critical attacks of headaches and convulsive syndromes, the sensitivity of different parts of the body is disturbed, painful sensations in the liver, kidneys and other organs are manifested.
Treatment
The treatment of diabetic encephalopathy can be divided into three main areas:
- Maintaining adequate blood sugar. It is keeping the blood glucose level at the required level that is the main method of treatment and prevention of DE. Doctors also advise not to neglect preventive therapy. This allows you to improve blood circulation to the tissues of the nervous system and trophism.
- Treatment of metabolic disorders. With this type of therapy, doctors recommend taking antioxidants (for example, Espa-lipon), vitamins of groups A, E, C and B. Also, patients are prescribed cerebroprotectors (Piracetam, etc.).
- Treatment of microangiopathy. Doctors correct vascular disorders with the help of Pentoxifylline, which normalizes blood flow in the body and reduces blood viscosity. This drug copes with the task of removing toxins from the patient’s brain.
Along with this, doctors everywhere use such drugs as Cavinton, Sermion, Vinpocetin and others for the treatment of angiopathies.