Treatment for Diabetic Neuropathy in Dubai
Experiencing burning, tingling, or a loss of sensation in your hands, feet, or limbs may signal diabetic peripheral neuropathy.
Understanding the Peripheral Nervous System:
The peripheral nervous system connects your brain and spinal cord (central nervous system) to the rest of your body, comprising three types of nerves:
- Sensory nerves conveying information about sensations like touch, pain, joint movement, balance, pressure, and vibration to the brain.
- Motor nerves transmitting messages from the brain to muscles for movement control.
- Autonomic nerves regulating bodily functions such as heart rate and digestion.
Significance of Neuropathy:
Neuropathy occurs when neurons or nerve cells in the peripheral nervous system sustain damage or destruction, disrupting communication between the body and brain. This condition can affect one or multiple nerves, with carpal tunnel syndrome being an example of neuropathy affecting a single nerve.
Symptoms of Neuropathy:
Symptoms vary based on the type and location of nerve damage and may include sharp pain, gradual numbness, extreme sensitivity to touch, decreased strength, abnormal blood pressure or heart rate, sexual dysfunction, nausea, muscle twitching, loss of muscle control, and dizziness.
Assessment and Diagnosis:
Diagnosis of Peripheral Diabetic Neuropathy (PDN) is primarily clinical, involving a history of neuropathic pain and confirmatory examination findings. The electro clinical diagnosis, which combines neurophysiological evaluation with a clinical history and examination, aids in providing a definitive diagnosis or narrowing down probabilities. Neurophysiology includes Electromyography (EMG) and Nerve Conduction Velocity (NCV) tests.
Role of Nerve Conduction Studies and Electromyography:
Neurophysiology evaluates nervous system function, and EMG and NCV tests play a crucial role in diagnosing and monitoring nervous disorders. These tests provide an electro clinical diagnosis, aiding in either confirming the diagnosis or guiding further investigations. Nerve conduction studies, involving mild electric shocks and detection of electric signals generated by nerves, are integral for diagnosing peripheral neuropathies.
Treatment of Diabetic Neuropathy in Dubai:
Diabetic neuropathy affects 50 to 70% of patients with diabetes and is objectively assessed through neurophysiology. Treatment approaches include intensive glycemic control, management of risk factors, addressing pathogenic mechanisms, and symptomatic pain management. Clinical guidelines recommend medications such as amitriptyline, duloxetine, gabapentin, pregabalin, and capsaicin for pain relief. Pathogenic treatments involve α-lipoic acid, benfotiamine, and aldose-reductase inhibitors.
There is a growing need for studies to evaluate the most potent drugs or combinations to manage PDN effectively, providing maximum pain relief and improving the quality of life.