Currently, a disease such as diabetes is considered the main "non-infectious epidemic of the 21st century." This is due to its prevalence and the earliest disability of patients, as well as high mortality rates among them. More than 200 million people on earth suffer from this serious disease, which ranks third in mortality after cardiovascular pathologies and oncological diseases. Diabetes annually takes more than three hundred thousand human lives.
One of the most common complications developing against the background of diabetes mellitus is diabetic polyneuropathy, which is characterized by the death of nerve fibers, leading to the development of foot ulcers and loss of sensitivity. In addition, the development of this complication leads to a number of conditions that reduce a person’s performance and threaten his life.
The term "neuropathy" refers to nerve damage caused by a disease, as well as complications of various systemic diseases. In the presence of numerous lesions of the peripheral nervous system, "polyneuropathy" occurs, which is a disease of the whole organism. Polyneuropathy manifests itself in the form of numbness and loss of sensitivity of the extremities, peripheral paralysis often occurs .
The central element in the occurrence of diabetic polyneuropathy is oxidative stress, the increase of which occurs as a result of the weakening of antioxidant defense systems. In diabetes mellitus, chronic hyperglycemia develops, since excess formation of glycated proteins occurs in endoneural blood vessels, leading to a decrease in blood flow and an increase in the resistance of the vascular wall. These changes contribute to the accumulation of free oxygen radicals in the nervous tissue , and thus a “vicious circle” arises - impaired endoneural circulation leads to the formation of free radicals, which cause even greater damage to the vascular endothelium.
Diabetic polyneuropathy: symptoms.
There are several options for the clinical manifestation of this disease. Early manifestations that may exist over many years include attenuation of Achilles reflexes and vibrational sensitivity. At the next stage of the development of the disease, acute and subacute lesions of individual nerves are manifested: more often the sciatic, femoral, median or ulnar. In addition, oculomotor, trigeminal and abducent nerves may be affected. The most common complaints are pain, paresis, and impaired muscle sensitivity. Further, progressive diabetic polyneuropathy manifests itself as pain in the limbs due to significant nerve damage with sensitive disorders and paresis. In addition, quite often there is a violation of autonomic innervation. With further progress of the disease, pain increases, some areas of the skin turn purple and even black, mummify tissues, trophic ulcers, itching and deformation of the feet occur.
Diabetic polyneuropathy develops in 85% of patients with diabetes mellitus, and its symptoms may appear several years after the detection of diabetes mellitus. Sometimes diabetic polyneuropathy can be the first symptom of diabetes, and indicate its latent course. This disease is the result of damage to neurons and processes of neurons of the peripheral and central nervous systems, which is often irreversible due to a violation of the regeneration processes in the presence of diabetes mellitus.
The main risk factors in the presence of which diabetic polyneuropathy develops (symptoms may be absent): duration of the disease (diabetes mellitus), patient age, degree of hyperglycemia, gender and high growth. The classification of this disease is complicated by a variety of symptoms.
Effective therapy of the underlying disease, i.e. diabetes mellitus, is extremely important to prevent the primary manifestations of diabetic polyneuropathy, and the most important condition is a decrease in the level of glycated hemoglobin, normalization of blood pressure and cholesterol, as well as lipoproteins and triglycerides and a decrease in blood coagulability.