Diabetic polyneuropathy: causes

At present, such a disease as diabetes is considered to be 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 severe disease, which ranks third in the lethality after cardiovascular pathologies and cancer. Every year, diabetes mellitus takes more than three hundred thousand human lives.

One of the most common complications developing against the background of diabetes is diabetic polyneuropathy, which is characterized by the death of nerve fibers, leading to the development of foot ulcers and the loss of their sensitivity. In addition, the development of this complication leads to a number of conditions that reduce the working capacity of a person and threaten his life.

The term "neuropathy" denotes nerve damage, which is caused by a disease, as well as complications of various systemic diseases. In the presence of numerous lesions of the peripheral nervous system, there is a "polyneuropathy", which is a disease of the whole organism. There is polyneuropathy in the form of numbness and loss of sensitivity of the limbs, peripheral paralysis often occurs.

The central link in the onset of diabetic polyneuropathy is oxidative stress, which is exacerbated by the weakening of antioxidant defense systems. In diabetes mellitus, chronic hyperglycemia develops, as in the endonevral blood vessels there is an excessive formation of glycated proteins, leading to a decrease in blood flow and increased resistance of the vascular wall. These changes contribute to the accumulation of free oxygen radicals in the nerve tissue , and thus a "vicious circle" arises - a violation of endoneural circulation entails the formation of free radicals that cause even greater damage to the vascular endothelium.

Diabetic polyneuropathy: symptoms.

There are several variants of the clinical manifestation of this disease. Early manifestations that may exist for many years include the weakening of achilles reflexes and vibrational sensitivity. At the next stage of the development of the disease, the acute and subacute lesion of individual nerves is manifested: more often the sciatic, femoral, median or ulnar nerves. In addition, oculomotor, trigeminal and abducent nerves can be affected . The most common complaints are the presence of pain, paresis and a violation of the sensitivity of the muscles. Further, progressive diabetic polyneuropathy manifests itself as pain in the extremities due to a significant lesion of nerves with sensory disorders and paresis. In addition, there is often a violation of vegetative innervation. With further progress of the disease, pain increases, some areas of the skin are dyed violet and even black, mummification of tissues occurs, trophic ulcers, itching and deformity of the feet occur.

Diabetic polyneuropathy develops in 85% of patients with diabetes mellitus, and its symptoms may appear several years after the discovery of diabetes. Sometimes diabetic polyneuropathy can become the first symptom of diabetes mellitus, and testify to its latent flow. This disease is the result of damage to neurons and processes of neurons of peripheral and central nervous systems, which is often irreversible due to disruption of 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, sex and high growth. The classification of this disease is complicated by the variety of symptoms.

For the prevention of primary manifestations of diabetic polyneuropathy, effective treatment of the underlying disease, i.e., diabetes mellitus, is extremely important, and the most important condition is the reduction to normal levels of glycated hemoglobin, normalization of blood pressure and cholesterol, as well as lipoproteins and triglycerides of blood and a decrease in blood clotting.