Diabetes: Complications of Diabetes

The most important information you need to improve your health

,

• Publisher: Adams Media
• Year: 2012
• eBook ISBN: 9781440540820
• Topic: Medicine
• Subtopic: Diseases & Allergies

If you or a family member has been diagnosed with diabetes, you may feel overwhelmed by the challenges associated with this disease. The Everything® Healthy Living Series is here to help. These concise, thoughtful guides offer the expert advice and the latest medical information you need to improve your health. Diabetes can cause complications like neuropathy, vascular disease, and glaucoma. But good health habits and regular maintenance can help you to reduce the likelihood of serious problems. You'll learn how to recognize warning signs and lower the risk of short- and long-term side effects.
"

Complications — Head to Toe

Your body is equipped with 60,000 miles of blood vessels and wired with a whopping 100,000 miles of nerve fibers. A clog here, some corrosion there, and all this hardware suffers from the strain. Diabetes is like a bad tenant, backing up pipes and short-circuiting wiring. You may not be able to evict it, but you can do your part to prevent long-term systemic complications with proper maintenance.

Neurological Complications

Diabetes is a risk factor for stroke, nerve damage, and cognitive impairment. While stroke is technically a cardiovascular complication caused by a blockage of blood to or a hemorrhage in the brain, it can cause impairment to memory, vision, speech, movement, and other brain functions in varying degrees of severity.

The other major neurological complications of diabetes are caused by neuropathy, or nerve damage. The exact way that diabetes causes nerve damage is not completely understood yet, but it’s thought that over time high levels of blood glucose damage the nerve cells, which unlike other cells don’t require an insulin “key” to allow glucose inside them. Researchers have also hypothesized that too much glucose causes depletion of nitric acid, which in turn cuts off blood supply to the nerves.

Peripheral Neuropathy (PN)

Peripheral neuropathy is often called stocking-glove syndrome because it most commonly affects the feet and hands. The condition can be particularly troublesome in the feet because of the chance that you may develop an injury that you don’t notice, and compound the problem through the simple act of walking.

Symptoms of peripheral neuropathy include the following:

• A feeling of “pins and needles”
• Tingling and/or burning sensations
• In some people, pain
• Numbness
• Balance problems (if PN is present in the feet)
• Reflex problems and muscle weakness

Fact

Neuropathies are either diffuse (affecting a wide area or several areas of the body) or focal (affecting a specific place on the body). Most neuropathic conditions related to diabetes are diffuse, including peripheral and autonomic neuropathy.

The antidepressant medications duloxetine (Cymbalta), amitriptyline, and desipramine may be useful in blocking pain signals, although side effects may be an issue for some patients. Gabapentin (Neurontin) and pregabalin (Lyrica), both anticonvulsant drugs, are also effective treatments for many people with PN and have the additional advantage of having few side effects. A number of studies have also shown promising treatment results with alpha lipoic acid (ALA) treatment, although ALA is not FDA-approved for this particular use at this point in time.

Topical (on the skin) treatment with lidocaine, evening primrose oil, or with capsaicin cream, which contains a substance derived from hot peppers that helps to block pain signals, may also be recommended by your doctor. And some anecdotal success has been reported in treating PN with acupuncture and with transcutaneous electronic nerve stimulations (TENS), a procedure that uses electrical waves to block pain signals.

Essential

If you have painful peripheral neuropathy and have difficulty sleeping because of it, you may want to invest in a bed cradle. A bed cradle is a device that elevates sheets, blankets, and other bedding above sensitive spots on feet and legs so you can sleep in comfort but still stay warm.

Anodyne therapy is another PN therapy using flexible pads containing a series of light-emitting diodes (LEDs) that use infrared light and energy to penetrate the skin. The light energy and heat is purported to improve circulation and reduce pain. Pads can be placed on the feet, hands, or elsewhere. Published research has conflicted on whether or not anodyne therapy has any lasting therapeutic value in the treatment of PN, and further studies are needed to make this determination.

Autonomic Neuropathy

While many people with diabetes are aware of the signs and symptoms of PN, significantly fewer are educated about, or tested for, autonomic neuropathy. A stealth disorder, autonomic neuropathy short-circuits the nerves that control the sympathetic (autonomic or involuntary) nervous system. Blood pressure, heart rate, perspiration, salivation, gastrointestinal and bladder function, sexual potency, and vision can all be impaired by autonomic neuropathy damage.

Autonomic neuropathy causes a wide spectrum of nonspecific symptoms ranging from constipation and diarrhea to dizziness and excessive perspiration. Unfortunately, these are also common signs of a number of medical conditions, which makes autonomic neuropathy particularly difficult to detect without regular screening. Often, a diagnosis isn’t made until organ damage has occurred.

Autonomic neuropathic symptoms can affect many parts of the body:

• Cardiovascular system: Symptoms include dizziness, drop in blood pressure, no variation in heart rate, elevated resting heart rate, shortness of breath, and perspiration. Possible complications: orthostatic hypotension, silent heart attack.
• Digestive system: Symptoms include constipation, diarrhea, bloating and nausea, and premature feeling of fullness. Possible complications: gastroparesis.
• Genitourinary system: Symptoms include urinary tract infections, urinary incontinence, vaginal dryness, inability to maintain erection, and decreased or increased urination. Possible complications: neurogenic bladder, nephropathy (kidney damage), impotence.
• Sudomotor system: Symptoms include increased perspiration (trunk and face), decreased perspiration (extremities), and dry, thick skin on hands and feet. Possible complications: skin rashes and infection.
• Vision: Symptoms include small pupils and no pupil response to light. Possible complication: impaired night vision.

Cardiovascular Autonomic Neuropathy (CAN)

This disorder begins silently without symptoms of chest pain or discomfort (angina), and often remains undetected until serious myocardial infarction (death of a portion of the heart muscle due to lack of oxygen) has occurred. As a result, these “silent heart attacks” often pass without proper medical attention.

If you experience any unexplained shortness of breath, w...

Table of contents

• Cover
• Title Page
• Contents
• Introduction
• Complications — Head to Toe
• The Diabetic Foot
• Also Available
• Copyright Page