Acute neuropathy, whose presentation is very rare, usually disappears after a few weeks or months after landing for a while normalization of blood glucose levels. Chronic neuropathy does not disappear, but can be kept under control by an optimization of metabolic control of diabetes.

How is diabetic neuropathy and what types of medications are used?

The most important aspects in the treatment of diabetic neuropathy are to control blood glucose levels and daily examination of the feet to prevent the development of ulcers.

The decrease in sensitivity can not be treated with medication. The pain experienced by patients with diabetic neuropathy, however, can be controlled with various medications, such as:

- Mild pain reliever (acetaminophen, aspirin)

- Mild opiates

- In specific cases tricyclic antidepressants

Elastic stockings for the legs can be used in patients with dizziness when incorporated quickly.

Nausea and vomiting can be controlled with antiemetic medication with cisapride.

Tetracycline can be used to treat diarrhea.

Learning the technique of catheterization of the bladder by the patient may be useful in people with such problems.

Impotence can be treated with oral or injectable preparations.

The best way to prevent diabetic neuropathy and its consequences, is to strive to maintain high levels of blood glucose as close to normal.

Neuropathy occurs most frequently in the lower limbs. This is the reason why everyone with diabetes should maintain good hygiene and inspect their feet daily to prevent sores. This is a fundamental aspect in the treatment, since the absence of proper care may result in the need for amputation.

All people with diabetes should visit a podiatrist regularly to treat corns, nail care, etc..

How is the diagnosis of diabetic neuropathy?

For the clinical diagnosis of diabetic neuropathy the doctor will be interested in the following areas:

- Presence of the most common symptoms

- Answers to reflections

- Sensitivity to vibration using a tuning fork

- Blood pressure lying down and standing

- Results of the electrocardiogram

- Other areas of interest, according to the findings and opinion of the physician.

Patients with predominantly sensory neuropathy may experience pain (perceived as a sensation of tingling, pricking, stinging or burning, which usually occurs at night, sometimes describe a feeling of walking on cotton), but more often in people who suffer from this type of neuropathy is loss of sensation or diminished sense of touch. The decrease in sensitivity occurs more frequently in the legs and feet, and less frequently, arms and hands.

Neuropathy with involvement of the control of movement and muscle function (motor neuropathy) occurs more infrequently. The symptoms of neuropathy involve a reduction in muscle function, manifested by weakness in the arms and legs. In some cases, the disorder leads to alterations in gait and poor alignment of joints, mainly in the feet.Neuropathy of the autonomic nervous system, ie it affects the internal organs, may lead to the following:

- Dizziness, especially after joining in too fast

- Nausea and vomiting after meals

- Diarrhea or constipation

- Problems with urination

- Changes in the perception of the symptoms of hypoglycemia (low blood glucose)

- Erectile Dysfunction (impotence) in men

Neuropathy is the name given to many of the disorders affecting the nervous system. Diabetic patients not adequately care for glycemic control are at risk of developing diabetic neuropathy, that is, a nervous system disorder resulting from poorly controlled diabetes.

This condition can be acute or chronic. Acute neuropathy usually disappears when achieved adequate control of diabetes, while chronic neuropathy is accompanied by major alterations and maintained.

What are the types of diabetic neuropathy?

There are three types of diabetic neuropathy, which affects the nervous system in different ways:

- Predominantly sensory neuropathy with impaired tactile or painful.

- Motor neuropathy, ie, alterations in muscle function.

- Autonomic neuropathy, which affects the functioning of internal organs and blood vessels deteriorate those nerves that are responsible for acting on them.

What is the cause of diabetic neuropathy?

Diabetic neuropathy is caused by prolonged poor control of diabetes, ie, elevated blood glucose levels for a long time. When the concentration of glucose in the blood rises above certain levels, the nerves throughout the body gradually begin to be damaged.

Luckily it is a disease that can be treated successfully in most cases. The treatment of diabetes is something that is highly developed, and there are many tools that they use doctors to treat their patients with diabetes.

Diabetes is closely related to food. The dietary control is essential to any treatment for diabetes. Diabetics who are well aware of this, and have to control the level of glucose in the blood almost constantly and carefully choose food according to each situation.

Body weight also affects diabetes. It tries to maintain weight loss by controlling the calories consumed and exercise regularly. This eliminates toxins and improves your metabolism, plus the consumption of glucose by our bodies is compounded by the working muscles.

A balanced diet is very important for people with diabetes. It must balance the consumption of carbohydrates, proteins and fats as indicated by the doctor or nutritionist.

It seeks to achieve or maintain a level of adequate blood lipids. Cholesterol-rich foods should be eliminated from the diet as in diabetics, this may mean a high risk of cardiovascular disease.

The kidney is an organ commonly affected by diabetes because it undergoes a major requirement to balance the metabolic processes. This is why it is necessary to also check the consumption of foods with high sodium intake of minerals, chromium and zinc. Without implying a lack of essential nutrients, among which are these and many other minerals and vitamins.

In this regard, Dr. Rhadames Figueroa, Merck Laboratories Medical Manager, explains that an adequate intake of vitamin A (retinol), which is necessary to preserve the integrity and functionality of tissues, thus keeping functions such as vision or healing. As an antioxidant, vitamin A decreases the oxidation of lipids that are part of the membranes of cells throughout the body.

For its part, Vitamin B1 (Thiamin) helps keep blood vessels in good condition with which delays the formation of atherosclerotic plaque, which is responsible for the blockage of blood vessels.

“A key feature in the development of diabetes is hyperglycemia, which produces a disorder of proteins and other molecules known as glycation, causing the loss of function of the molecule and therefore the affected organ. Thus Vitamin B6 (pyridoxine) counteracts the glycation process, which reduces the chances of complications of the disease, “said Figueroa.

Similarly, Vitamin B12 (Cyanocobalamin) is essential for maintaining the integrity and functioning of the nervous system cells, particularly the formation of neurotransmitters.

Furthermore, through studies in patients with diabetes and blood vessel damage, it has been observed by the low levels of vitamin C (ascorbic acid), which must be restored to prevent further artery damage. As for his role as an antioxidant, vitamin C reduces oxidation of lipids and in turn slows the development of atherosclerosis. It is noteworthy that vitamin C and E combination is synergistic and reduces mortality from cardiovascular disease such as myocardial infarction or stroke.

Similarly, the medical manager of Merck Laboratories, explains another intervener to avoid the consequences that diabetes occurs in our body is Folic Acid, “This stimulates increased lumen diameter of blood vessels, ie, vasodilation, which is particularly useful in patients at high risk of vascular disease, as the case we are dealing with. “

Also, the Zinc is highly relevant in people with type 2 diabetes, since some of these patients have problems developing the mineral during the course of their disease. Zinc has an important antioxidant capacity thereby modulating the activity of insulin.

As a factor in glucose tolerance, Chromium has shown its ability to prevent type 2 diabetes and reduce blood sugar. Chromium may improve insulin sensitivity in patients with both diabetes types 1 and 2, as in people with glucose intolerance and gestational diabetes.

Also, selenium exerts different actions on the endocrine system through its effect on some compounds called selenium-dependent enzymes, which are able to modify cellular functions through its antioxidant actions. In the particular case of diabetes, its administration decreases the incidence and progression of late complications of the disease.

The increase of obesity in children and adolescents is a result of changes in diet (increased consumption of high calorie diet from junk food “rich in fat and carbohydrates) and decreased physical activity, because children spend more television viewing, computer and / or electronic games.

Until about ten years, children and adolescents with type 2 diabetes accounted for about 2% of all cases (type 2 diabetes accounts for over 90% of cases of diabetes), but now children and adolescents with diabetes than 8% of cases.

Type 2 diabetes is a disease characterized by high levels of glucose in the blood, which occurs when the body lacks the ability to effectively use the insulin it produces. This type of diabetes not requiring insulin intramuscularly.

Although many children and adolescents with type 2 diabetes show no symptoms (asymptomatic), others have excessive thirst, constant urination, increased appetite, weight loss, tiredness or fatigue and blurred vision.

This problem is doubly alarming because it not only means greater social and economic burden to their family and country, but also implies that this population is at risk of developing an early complications of diabetes such as retinopathy, cardiovascular disease, diabetic foot, kidney failure and neurological problems.

One of the main measures to prevent this disease is that families adopt healthier lifestyles, including proper nutrition and physical activities.

According to studies by proper diet and exercise practice up to 60% reduces the risk of developing type 2 diabetes in children. In adolescents the least number of hours of television and physical activity decrease body weight and improve carbohydrate tolerance.

Risk Factors
In addition to obesity and overweight, the risk factors for the onset of diabetes in children and adolescents are: family history of diabetes (first or second grade), insulin resistance, have had low or high birth weight and the mother has the disease or have had gestational diabetes.
Faced with these risk factors is important in monitoring and evaluation of the specialist physician.

Useful information
- In Peru is estimated at two million the number of people who would suffer from diabetes mellitus.
- Many diabetics have no symptoms so that about 50% of these people do not know who is a carrier of this disease.
- Poor diet and sedentary lifestyle has led to an increase of 6% to 18% of obesity and overweight in children over the past ten years.
- The complications of diabetes in the short and long term are: cardiovascular disease, kidney disease (diabetic nephropathy), neurological disease (diabetic neuropathy) and eye disease (diabetic retinopathy).
- It is estimated that within the next 15 years, the current world figure will increase by 50% and there will be about 40 million children and adolescents affected, of whom 22 million are children under five years.

Scientists have found a good use for snuff after the development of genetically modified plants which contain a drug that could halt type 1 diabetes.
The move marks the latest advance in the emerging field of molecular farming, which may offer a way to make cheaper biotechnology drugs and vaccines that traditional factory systems.

European researchers said they had produced plants of snuff, which contains a potent anti-inflammatory protein called interleukin-10 (IL-10) that could help patients with insulin-dependent type 1 diabetes and other autoimmune diseases.

A series of agrochemical companies, including Bayer and Syngenta, have been seeking ways to make vegetable protein complexes that act with drugs while progress has been slow.
For now, drugs and vaccines of antibodies are produced in cell cultures in stainless steel fermenters.

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