Diabetic neuropathy, a nerve disorder is a debilitating consequence of diabetes. It is the most prevailing complication of Type 1 and Type 2 diabetes that can cause significant morbidity and mortality. Nerves are damaged in this disease which is caused by long-term high blood glucose levels. Diabetic neuropathy has affected approximately 30% of diabetic patients. It usually develops slowly, sometimes over the course of several decades. Diabetic neuropathy encompasses a variety of clinical or subclinical presentations including
- Peripheral neuropathy
- Autonomic neuropathy
- Proximal neuropathy
- Focal neuropathy
- Distal symmetrical polyneuropathy (DSP)
Peripheral neuropathy usually affects the feet and legs and people affected by it may not feel an injury or sore on their foot. Autonomic neuropathy involves digestion problems, sexual and bladder problems, and cardiovascular problems. Proximal neuropathy often affects the hips, buttocks, or thighs. Focal neuropathy is also known as mononeuropathy most often affects the hand, head, torso, or leg. Distal sensory polyneuropathy is mostly seen in people with HIV and it involves tingling, burning pain, toe and distal foot numbness, paraesthesia with or without neuropathic pain. The pathogenesis of diabetic neuropathy comprises proinflammatory processes, polyol pathway, PKC activity, oxidative stress, and further involvement of glycation and advanced glycation end‐products and cellular and trophic factors. The most common symptom is painful “pins and needles” in the feet. Common signs and symptoms of diabetic neuropathy are sensitivity to touch, difficulty with coordination when walking, nausea, indigestion, increased heart rate, bladder problems, dizziness, vaginal dryness, muscle weakness, and erectile dysfunction. Diabetic neuropathy leads to nerve damage which is caused by high blood sugar levels sustained over a long period of time. Other factors responsible can be damage to the blood vessels, mechanical injury, and smoking or alcohol use. Treatment of diabetic neuropathy represents a therapeutic challenge as there is no cure for this disease. A wide variety of drugs have been shown to significantly reduce neuropathic pain including anticonvulsants, antidepressants, and opioids. Other agents currently associated with pharmacological treatments are capsaicin topical cream, lidocaine patch, alpha-lipoic acid, and isosorbide dinitrate spray. These drugs can have certain side-effects therefore, it is necessary to shift our attention towards ayurvedic treatment for the possibilities of safer and cost-effective treatments. According to the study, in Ayurveda classics, symptoms like Vata and Pitta Dosa are involved in diabetic neuropathy. Atibala (Abutilon indicum) and Bhumyamalaki (Phyllanthus niruri) are the plants that can pacify these classic symptoms. Ayurvedic drugs are effective in different ways including-
- Reducing sensations like vibration, cold, and heat
- Reduction in numbness, tingling, burning sensation, and pain
Future pharmacological therapies may involve options like targeting those growth factors which are highly responsible for causing diabetic neuropathy.
SNI Publications invites you to share your knowledge and recent advancement on Diabetic Neuropathy by publishing your work with the Journal of Diabetic Nephropathy and Diabetes Management also a small piece of information that can be shared here itself in the comment section.