00:00Diabetes has been a well-recognized disease since the beginning of time.
00:06Of the millions of diabetic patients worldwide, one quarter to one half will develop neuropathy over time.
00:16Diabetic neuropathy is defined as symptoms and signs of neuropathy in a diabetic patient after other causes are excluded.
00:26It is therefore a diagnosis of exclusion.
00:32But how does a patient with diabetic peripheral neuropathy present?
00:37Typically, patients with diabetic neuropathy complain of numbness, burning, tingling, and pain in the distal parts of their feet and later their hands.
00:51Curiously, only about 40 to 50% of patients with diabetic peripheral neuropathy develop pain.
01:00Just as baffling is why patients with type 2 diabetes develop neuropathy more frequently than patients with type 1 diabetes.
01:14The neuropathy usually presents in a symmetrical and distal distribution, affecting the sensory nerves before affecting the motor nerves.
01:29But diabetic neuropathy is not limited to the limbs.
01:36It can also affect the nerves that control our bodily functions as well, causing abnormal heartbeats, low blood pressure withstanding, abnormal sweating, constipation, slow emptying of the stomach,
01:55urinary dysfunction, and erectile dysfunction, and erectile dysfunction.
02:01The strongest predictors of diabetic peripheral neuropathy are long-standing diabetes and poor diabetic control.
02:13There is still much debate as to the cause of diabetic neuropathy.
02:18Scientists believe it may be caused by high glucose levels and abnormal blood lipids,
02:26which cause the increased production of highly damaging molecules known as reactive oxygen species.
02:38These can damage the nerve cells and produce the familiar symptoms.
02:43Other possible causes are the buildup of abnormal molecules formed as a result of high blood sugar levels known as AGEs or advanced glycation end products.
03:02These are harmful to the nerve cells.
03:05Still, a third theory is that resistance to the action of insulin in the nerves leads to degeneration and reduced regeneration of nerve fibers.
03:21This causes damage to the nerve cells and the surrounding cells that promote nerve conduction, known as Schwann cells.
03:31Yet a fourth possible mechanism may involve damage to the tiny blood vessels that feed the nerves in our body.
03:44Metabolic changes in diabetic patients can cause dysfunction in the lining of the tiny vessels feeding the nerves in the legs and in other parts of the body.
03:56The reduced circulation to the nerves can damage the nerves, causing them to trigger off impulses automatically or with minimal stimulation.
04:12Pain that occurs from stimuli that are not normally painful is called allodynia.
04:20Despite the ongoing debate as to the origin of this complication of diabetes, one thing is clear.
04:32Long-standing diabetes and poor diabetes control are associated with a higher incidence of diabetic peripheral neuropathy.
04:44Other risk factors include age, excessive height, obesity, high blood pressure, high cholesterol, smoking, and alcohol abuse.
04:56The best way for you to avoid diabetic peripheral neuropathy is keeping your A1C below 7 or as prescribed by your provider,
05:08although the benefit is only modest in type 2 diabetes.
05:12Finally, remember to check your vitamin B12 level if you're on metformin, since metformin can lower B12 levels and this may worsen DPN or diabetic peripheral neuropathy symptoms.
05:29I hope you found this video useful.
05:32If you did, like and share with your friends and family.
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05:39Until the next video, stay healthy and stay safe.
05:44Stay safe.
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