- Results: sensory and motor impairments, postural hypotension, delayed gastric
emptying, diarrhea, impaired GU function
- Result from the thickening of the capillary membrane and destruction of myelin
sheath which disrupt nerve conductions.
The prevalence increases with the age of the patient and the duration of the disease and
may be as high as 50% in patients who have had diabetes for 25 years.
The two most common types of diabetic neuropathy are sensorimotor polyneuropathy
and autonomic neuropathy.
- Bilateral sensory disorders
- Appear first in toes, feet, and progress upward to fingers and hands
- Tingling, decrease in proprioception , and a decreased sensation of light touch
- Treatment
- Controlling BS delay the onset.
- Analgesics to control pain
Proprioception (awareness of posture and movement of the body and of position and
weight of objects in relation to the body
Complication: Autonomic Neuropathy
- Involves numerous body systems such as:
- Cardiovascular (slight tachycardia, orthostatic hypotension & silent MI).
- Gastrointestinal (Delayed gastric emptying , N&V, early satiety, variation of BS
absorption) - Genitourinary (urinary symptoms of neurogenic bladder, UTI, erectile dysfunction)
- Hypoglycemic unawareness (DM diminish function of adrenal medulla)
Delayed gastric emptying may occur with the typical gastrointestinal symptoms of
early satiety, bloating, nausea, and vomiting. ―Diabetic‖ constipation or diarrhea
(especially nocturnal diarrhea) may occur as a result. In addition, there may be
unexplained wide swings in blood glucose levels related to inconsistent absorption of
the glucose from ingested foods secondary to the inconsistent gastric emptying.
Foot and Leg Problems
- 50% -75% of lower extremity amputations are performed on people with diabetes.
- More than 50% of these amputations are thought to be preventable.