Diabetic neuropathy: the most effective dietary supplements

Diabetic neuropathy is a common complication of diabetes, characterized by nerve damage resulting from chronic hyperglycemia. It primarily affects the peripheral nervous system. This condition presents with a variety of sensory, motor, and autonomic symptoms, and its impact varies considerably from one person to another.

Pathophysiology

Diabetic neuropathy results from several complex, interrelated pathophysiological mechanisms:rnrn• Hyperglycemia: It plays a central role by inducing a cascade of metabolic disturbances that damage nerves. Excess intracellular glucose is converted to sorbitol, causing osmotic disturbances and oxidative stress, leading to impaired cellular function and neuronal apoptosis.rnrn• Ischemia: Diabetic microangiopathy affects the small blood vessels that supply the nerves (vasa nervorum), resulting in reduced blood flow to the nerves, which leads to nerve ischemia and irreversible axonopathy.rnrn• Immune dysfunction: Autoimmune mechanisms may also contribute to neuropathy by triggering inflammatory responses against nerve cells, thereby worsening the damage.

Classification

Diabetic neuropathy can be classified into several subtypes, depending on the clinical manifestations and the areas of the nervous system affected:rnrn• Distal symmetric polyneuropathy: The most common form, primarily affecting the lower extremities, with sensory and motor symptoms.rnrn• Autonomic neuropathy: Affects the body's automatic functions, such as digestion, urination, and cardiovascular regulation.rnrn• Focal or multifocal neuropathies: Includes mononeuropathies, such as cranial nerve palsies, and radicular syndromes (root involvement), such as asymmetric proximal neuropathy.

Symptoms

Symptoms vary according to the type of diabetic neuropathy:rnrn• Distal symmetric polyneuropathy: Paresthesias, burning pain, decreased sensation, muscle weakness, loss of tendon reflexes.rnrn• Autonomic neuropathy: Orthostatic hypotension, gastroparesis, erectile dysfunction, abnormal sweating.rnrn• Focal neuropathies: Acute pain, localized muscle weakness, partial paralysis.

Treatment

Glycemic control: Maintaining blood glucose close to normal is essential to slow the progression of nerve damage.rnrnPain management: Use of anticonvulsants (such as gabapentin), tricyclic antidepressants (amitriptyline), and opioid analgesics for severe pain.rnrnSpecific therapies: In some cases, intravenous immunoglobulins may be used, particularly for chronic inflammatory neuropathies.

Prevention

Prevention of diabetic neuropathy relies primarily on strict glycemic control, combined with management of cardiovascular risk factors, such as hypertension and hyperlipidemia. Regular monitoring of neurological symptoms is also recommended to allow early intervention.rnrn