Everything You Should Know About Diabetic Neuropathy

这是常见的神经病变的症状出现radually. In many cases, the first type of nerve damage to occur involves the nerves of the feet. This can lead to the symptom of sometimes painful “pins and needles” in your feet.

Symptoms vary depending on the areas affected. Common signs and symptoms of the different types of diabetic neuropathy include:

• sensitivity to touch
• loss
• difficulty with coordination when walking
• 麻木or pain in your hands or feet
• burning sensation in feet, especially at night
• 肌肉弱点或浪费
• bloating or fullness
• 恶心，消化不良或呕吐
• 腹泻或constipation
• 你站起来的头晕
• excessiveor decreased sweating
• bladder problems, such as incomplete bladder emptying
• vaginal dryness
• 勃起功能障碍
• 无法感测低血糖
• 视觉问题，如双方视觉
• increased heart rate

术语神经病变用于描述几种类型的神经损伤。在患有糖尿病的人中，有四种主要类型的神经病变。

1.外周神经病变

最常见的神经病变是外周神经病变。周围神经病变通常会影响脚和腿，但它也可以影响臂或手。症状是多样的，并且可以轻度至严重。它们包括：

• 麻木
• tingling or burning sensations
• extreme sensitivity to touch
• insensitivity to hot and cold temperatures
• sharp pain or cramping
• muscle weakness
• 失去平衡或协调

Some people experience symptoms more often at night.

If you have peripheral neuropathy, you may not feel an injury or sore on your foot. People with diabetes often havepoor circulation, which makes it more difficult for wounds to heal. This combination increases the risk for infection. In extreme cases, infection can lead to amputation.

2. Autonomic neuropathy

The second most common type of neuropathy in people with diabetes isautonomic neuropathy。

自主神经系统在您的身体中运行其他系统，您无法有意识控制。许多器官和肌肉由它控制，包括您的：

• 消化系统
• sweat glands
• 性器官和bladder
• 心血管系统

消化问题

Nerve damage to the digestive system may cause:

• constipation
• diarrhea
• swallowing trouble
• gastroparesis, which causes the stomach to empty too slowly into the small intestines

Gastroparesis causes a delay in digestion, which can worsen over time, leading to frequent nausea and vomiting. You’ll typically feel full too quickly and be unable to finish a meal.

Delayed digestion often makes it more difficult to control blood glucose levels, too, with frequently alternating high and low readings.

Also, symptoms ofhypoglycemia, such as sweating and heart palpitations, can go undetected in people with autonomic neuropathy. This can mean not noticing when you have low blood sugar, increasing the risk for a hypoglycemic emergency.

性和膀胱问题

自主神经病变也可能导致性问题，如勃起功能障碍，阴道干燥或难度达到orgasm。Neuropathy in the bladder can causeincontinenceor make it difficult to fully empty your bladder.

Cardiovascular problems

控制心率和血压的神经损坏可以使它们更慢地响应。你可能会遇到一滴blood pressure当你坐下或躺下后站起来时，或躺着，或者当你施加自己时，感到眩晕或头晕。自主神经病变也可能导致心率异常快。

Autonomic neuropathy can make it difficult to identify some of the symptoms of aheart attack。You may not feel any chest pain when your heart isn’t getting enough oxygen. If you have autonomic neuropathy, you should know the other warning signs for heart attack, including:

• profuse sweating
• pain in the arm, back, neck, jaw, or stomach
• shortness of breath
• nausea
• lightheadedness

3. Proximal neuropathy

A rare form of neuropathy is proximal neuropathy, also known as diabetic amyotrophy. This form of neuropathy is more commonly seen in adults over 50 years old with fairly well controlled type 2 diabetes, and more often in men.

它经常影响臀部，臀部或大腿。您可能会突然遇到突然且有时剧烈疼痛。腿部的肌肉弱点可能会使在没有帮助的情况下难以站起来。糖尿病肌萎缩通常仅影响身体的一侧。

症状发作后，他们通常会变得更糟，然后最终开始缓慢提高。幸运的是，大多数人在几年内收回，即使没有治疗。

4. Focal neuropathy

局灶性神经病变，或单一病变，当对一个特定神经或神经损伤发生损伤时，会导致受影响区域的弱点。这通常发生在你的手中，头部，躯干或腿部。它突然出现，通常非常痛苦。

Like proximal neuropathy, most focal neuropathies go away in a few weeks or months and leave no lasting damage. The most common type is腕管综合症。

虽然大多数人不感受到腕管综合征的症状，但关于 25 percent 糖尿病患者有一定程度的神经compression at the wrist.

Symptoms of focal neuropathy include:

• pain, numbness, tingling in fingers
• an inability to focus
• double vision
• aching behind the eyes
• Bell’s palsy
• pain in isolated areas, such as the front of the thigh, lower back, pelvic region, chest, stomach, inside the foot, outside the lower leg, or weakness in big toe

糖尿病神经病变是由高位引起的blood sugar levelssustained over a long period of time. Other factors can lead to nerve damage, such as:

• damage to the blood vessels caused by high cholesterol levels
• 机械损伤，如腕管综合征引起的伤害
• lifestyle factors, such as smoking or alcohol use

Low levels of vitamin B-12也可以导致神经病。Metformin, a common medication used to manage diabetes, can decrease levels of vitamin B-12. You can ask your doctor for a simple blood test to identify any vitamin deficiencies.

A doctor will determine whether or not you have neuropathy, starting by asking about your symptoms and medical history. You’ll also have a physical examination. They’ll check your level of sensitivity to temperature and touch, your heart rate, blood pressure, and muscle tone.

Your doctor may do a filament test to test the sensitivity in your feet. For this, they’ll use a nylon fiber to check your limbs for any loss of sensation. A tuning fork may be used to test your vibration threshold. Your doctor may also test your ankle reflexes.

There’s no cure for diabetic neuropathy, but you can slow its progression. Keeping your blood sugar levels within a healthy range is the best way to decrease the likelihood of developing diabetic neuropathy or slow its progression. It can also relieve some symptoms.

戒烟and exercising regularly are also parts of a comprehensive treatment plan. Always talk to your doctor or healthcare team before beginning a new fitness routine. You may also ask your doctor aboutcomplementary treatmentsor神经病变的补充剂。

Pain management

药物可用于治疗由糖尿病神经病变引起的疼痛。与您的医生讨论可用的药物及其潜在的副作用。已经显示出几种药物有助于症状。

You may also want to consider alternative therapies, such asacupuncture。Some 研究 发现辣椒素有用。当与药物结合使用时，替代疗法可以提供额外的浮雕。

Managing complications

Depending on your type of neuropathy, your doctor can suggest medications, therapies, or lifestyle changes that may help deal with symptoms and ward off complications.

For example, if you have problems with digestion as a result of your neuropathy, your doctor may suggest you eat smaller meals more often and limit the amount of fiber and fat in your diet.

If you have vaginal dryness, your doctor may suggest a lubricant. If you have erectile dysfunction, they may prescribe medication that can help.

外周神经病变对糖尿病的人们非常常见，可以导致serious foot complications, which in turn can lead to amputation. If you have peripheral neuropathy, it’s important to take special care of your feet and to quickly get help if you have an injury or sore.

Diabetic neuropathy can often be avoided if you管理你的血糖警惕地。为此，请保持一致：

• monitoring your blood glucose levels
• taking药物as prescribed
• managing yourdiet
• being active

如果您培养糖尿病神经病变，请与您的医生密切合作，并遵循他们的建议，以减缓其进展。通过适当的护理，您可以减少对神经的损害并避免并发症。

Read this article in Spanish.