Diabetic Neuropathy: Explanations of Dr. Curimbacus

On Thursday 28 November 2019, the Darné Clinic gave an open talk at its premises, with the title “Neuropathy and Diabetes”. It was hosted by Dr. Afzal Curimbacus, neurologist. Here is a detailed account.

Diabetes: a quick reminder

Diabetes is a chronic, metabolic disease that occurs when the pancreas does not produce enough insulin or when the body is unable to use the insulin produced by the body. 20.5% of the Mauritian population has diabetes. The rate of prediabetics is also quite alarming: "We have 19.9% ​​prediabetics in Mauritius. It is essential that these people take their health in hand, otherwise they have 50% risk of developing diabetes in the next 10 years ", stated the doctor.

Diabetic neuropathy

Among the many possible complications of diabetes, there is neuropathy. It corresponds to the damage of the nervous system. Diabetes can affect the nerves of the body in different ways. A rise in the blood sugar level, for instance, can damage the nerves in the long run. On the other hand, oxidative stress can damage arteries. This also gives rise to the occlusion of the small arteries that feed the nerves.

50 to 70% of people with diabetes are at risk of neuropathy. The pathology mainly affects the lower limbs (peripheral neuropathy) or the different organs (dysautonomic neuropathy).

Peripheral neuropathy

The peripheral nerves control the movements of the muscles and regulate the movements of the muscles and the sensations (hot, cold, pain ...). Most often, peripheral neuropathy affects the lower limbs. The symptoms are usually as follows:

• Numbness
• Throbbing pains
• Tingling
• Burning sensations
• Tingling
• Loss of sensation
• Damage to the nerves also causes atrophy and muscle deformity and muscle weakness. It also increases the risk of wounds.

Dysautonomous neuropathy

The following organs (or group of organs) are affected:

• The heart: this is usually manifested by orthostatic vertigo. The patient feels dizzy and weak when moving from a sitting position to a standing position.
• The gastrointestinal tract: this is manifested by gastroparesis (food stays in the stomach) and constipation.
• The genitourinary system: this is manifested by erectile dysfunction or bladder dysfunction.

Preventive measures

To prevent the onset or aggravation of neuropathy, it is essential to monitor your blood sugar. We must also fight against risk factors such as:

• Tobacco
• Alcohol
• Physical inactivity
• Retinopathy and nephropathy
• Obesity
• Hypertension

One of the greatest dangers is the attack of the nerves of the foot; as there is a loss of sensation and poor blood circulation, the slightest injury in the foot may worsen and go unnoticed. Can then occur gangrene with the risk of amputation. The diabetic must always examine his feet (self-examination + examination by his doctor) and have irreproachable foot hygiene.

The treatment

Treatment is much more effective when administered early. To soothe the pain, there are medical treatments (anti-epileptics, for example) and non-medicated treatments (physiotherapy, acupuncture, massages ...). Concerning dysautonomic disorders, the solutions are as follows:

Medication intake as prescribed by your doctor, dietary and lifestyle measures and a salt diet to combat orthostatic hypotension

Medication intake (usually prokinetics) as well as hygienic and dietary measures to treat gastroparesis.

Oral treatment for erectile dysfunction.

If you are diabetic or prediabetic and think you have neuropathy, do not suffer in silence. Seek medical advice at the earliest.

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