Dr. R.Ravindranath

Diabetic neuropathy is a nerve disorder caused by diabetes. The high blood sugarfrom diabetes affects the nerves and over time increases a person's risk for nerve damage. Keeping blood sugar levels within the target range recommended by your doctor helps prevent diabetic neuropathy.

Types of Diabetic Neuropathy:
Diabetic neuropathy can be classified as Peripheral, Autonomic, Proximal, or Focal. Each affects different parts of the body in various ways...

Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, and hands.

Autonomic neuropathy affects the nerves that control involuntary body functions such as digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.

Proximal neuropathy causes pain in the thighs, hips, arms, or buttocks and leads to weakness in the legs and hands, resulting in difficulty in walking, standing, picking up objects, buttoning your clothes, etc.

Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.

How Diabetes Causes Damage to the Nervous System?
There are several factors that are likely to contribute to nerve damage through diabetes...

• High blood glucose, a condition associated with diabetes, causes chemical changes in nerves. These changes impair the nerves' ability to transmit signals. 
• High glucose levels affect many metabolic pathways in the nerves, leading to an accumulation of a sugar called sorbitol and depletion of a substance called myoinositol. These changes are the mechanism that causes nerve damage. Nitric oxide dilates blood vessels. In a person with diabetes, low levels of nitric oxide may lead to constriction of blood vessels supplying the nerve, contributing to nerve damage.
• Presence of mechanical injury like carpal tunnel syndrome in a diabetic patient worsens its symptoms and prognosis
• inherited traits increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use

Symptoms:

1. Numbness, burning sensations, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
2. Either hypersensitivity to touch or insensitivity, even to hot and cold temperatures
3. Weakness in muscles and loss of reflexes
4. indigestion, nausea, or vomiting
5. diarrhea or constipation
6. dizziness or faintness due to a drop in blood pressure after standing or sitting up
7. problems with urination
8. Changes in gait and balance
9. Injuries that are taking longer to heal and are more prone to infections

Prevent Diabetic Nerve Damage:
Keeping your blood sugar levels in your target range, set with your doctor, may help prevent nerve damage from ever developing. The best way to do this is by checking your blood sugar and adjusting your treatment. It is also important to get to and stay at a healthy weight by exercising and eating healthy foods.

Diabetic men usually are prone to suffering from erectile dysfunction, i.e., they are unable to maintain an erection while having sex. If you are suffering from diabetes for a long time, your nerves and blood vessel might get damaged. That will cause you to suffer from erectile dysfunction. Almost 35% to 75% diabetic men suffer from erectile dysfunction. This situation becomes more serious with age.

Causes: It involves various factors like impairment in the nerves, blood vessels, and also cause problems in proper muscle functioning. You need healthy blood vessels, nerves, as well as healthy male hormones and sexual desire to get an erection. Diabetes damages the nerves and blood vessels responsible for an erection. So even if you have the required amount of hormones and the desire, you might not be able to get a proper erection.

Treatment: If you are suffering from diabetes, and have a condition of erectile dysfunction, then the most common treatment for you is Sildenafil. Other medications, which you can take are tadalafil, avanafil, and vardenafil. But keep in mind that if you have any heart problems, then you should refrain from taking any of these medicines as they will further complicate situations for you. Consult your doctor in this case to know which will be the best treatment for you to cure erectile dysfunction. Other treatment methods are as follows:

1. Intracavernous injection therapy
2. Vacuum erection devices
3. Venous constriction device
4. Intraurethral therapy
5. Penile prostheses

The dosage of these medicines depends upon weight of the patient as well as presence or absence of other co-morbid conditions like hypertension, dyslipidemia, cardiac problems, kidney/liver diseases, etc. Prescription of these medicines also depends on the other medications that the patient is taking as these ED medicines have a lot of adverse drug-interactions. Hence, one must always consult a doctor before starting these medications.

 

The Role of Counselling for Treating Erectile Dysfunction:

Erectile dysfunction can be caused by psychological factors and once a man experiences erectile dysfunction it can have a major impact on their emotional well-being. A man may feel a loss of manhood, a loss of confidence, low self-esteem, angry and depressed and it may also affect his relationship or sexual encounters. Therefore, counselling is a crucial part of treatment in order to address these issues.
Does psychosexual counselling work?

Psychosexual counselling is most effective when a man's sexual partner is willing to be part of the treatment. Studies have shown that for men with stress-related ED, when the partner is involved in the therapy, the problem is resolved 50%-70% of the time. When the man must go through counselling alone, the results are less successful.

Psychosexual counselling is unlikely to work if a man drops out of treatment after just one or two sessions.

Sometimes, several sessions of psychosexual counselling can be helpful if a man is due to receive medical or surgical treatment for ED. A counsellor can help guide a couple towards agreeing on treatment, or help them improve their sexual communication and lovemaking skills. A man may benefit from counselling on his own regarding how to talk to his partner about penile injections or a vacuum constriction device, which are both treatments for ED. 

In case you have a concern or query you can always consult an expert & get answers to your questions! In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a common term which is referred to as a group of diseases that results in a high level of the sugar in the blood. The different types of diabetes which are most common are as follows.

Types of Diabetes

1. Type 1 Diabetes – This is a chronic condition where the pancreas produces very little or almost no insulin.
2. Type 2 Diabetes – This chronic condition affects the way in which the body processes the sugar present in the body.
3. Prediabetes – This is a condition where the level of sugar in the blood is high, but not high enough to be causing type 2 diabetes.
4. Gestational Diabetes – As the name indicates, this is the condition of a high level of sugar in the blood that affects only the pregnant women.

How are diabetes and weight loss interconnected?
Diabetes is a metabolic disorder, and some forms of diabetes are associated with sudden loss of weight. The unexplained and sudden loss of weight is a warning sign or a symptom of the onset of diabetes. There are a number of mechanisms behind this weight loss which is as discussed below.

1. High blood sugar: Both type 1 and type 2 diabetes can involve dramatic loss of weight over a number of days at the onset of the particular disease, but the situation is more common in the case of type 1 diabetes. The insufficient amount of insulin in the body prevents the cells of the body from getting the required amount of glucose from the blood to use as energy. In this situation, the body starts burning the fats to fulfill in energy requirements which result in a sudden loss of body weight.
2. Dehydration: In diabetes, frequent urination is a common symptom which makes the body lose all its fluid, but the intake of fluid is not enough to prevent this loss. Hence, the body is dehydrated, and kidneys tend to work harder for the filtration of the excess glucose in the body. Now this increased glucose present in the urine draws the required fluid from the tissues and thus making you lose a significant number of calories during urination. Hence the body loses weight.
3. Breakdown of muscles: If diabetes is not controlled properly, losing weight by wasting of the muscles is extremely common. Due to the deficiency of insulin, the synthesis of muscles in the body is decreased, and at the same time, the breakdown of muscles is increased. This results in the loss of body weight to a significant amount.

Thus, it is understood that the different types of diabetes and unexplained loss of weight with no significant cause are connected with each other. Weight loss, being a prevalent symptom during the onset of the condition, is a key symptom in diagnosis for diabetes.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a known and common medical condition in which glucose or sugar levels gradually build up in a person's bloodstream. In such conditions, enough insulin is not present for moving sugar inside your cells. When such a situation arises, sugar is utilized for obtaining energy. Due to this, your body will tend to rely on alternative sources of energy in the muscles, tissues, and organs. This process continues resulting in a chronic disorder.

Symptoms of chronic or Type 2 diabetes
Warning signs of type 2 diabetes usually develop very slowly. You might have it for years without even knowing about it. Due to excessive sugar building within your bloodstream, fluid tends to come out from tissues. In turn, your thirst might increase and lead to frequent and excess urination because of additional water consumption. If you have chronic diabetes and is unaware of it, then gradually fluid might be pulled out from eyes' lenses and lead to blurred vision along with an inability to focus properly.

Some patients with type 2 diabetes also get affected by frequent kidney, skin, bladder infections. Due to high blood sugar level, such infections might take a long time to heal completely. If you possess dark patches and velvety skin especially in the folds of neck and armpits or any other body parts, then it will be a wise decision to consult your physician immediately as it is another warning sign of chronic diabetes.

Besides increasing thirst, another basic and contradictory symptom of type 2 diabetes is increased hunger along with weight loss. Despite consuming more food than usual to cope up with the increased hunger, an individual having high blood sugar may lose weight. You might also feel irritated or tired if the cells of your body are deprived of sugar. Various other symptoms including foot pain, yeast infections, itchy skin, numb feeling, etc. are also present and the signs become severe and more dangerous with the progress of the disease.

What is the perfect time to visit a doctor?
If you notice any of the above mentioned symptoms of chronic diabetes, then that is the best or perfect time to see a physician. It is not mandatory that you will definitely have this health disorder if you observe any symptom within yourself. If you have excessive work pressure for a couple of days, then for sure you will feel exhausted. But, that does not mean your fatigue is the warning sign of diabetes. For being, sure enough, it is best to consult a trained medical practitioner.

Without proper treatment, diabetes can also become threatening to life. This chronic health disorder might result in complications related to heart, and during pregnancy, it can prove deadly.Maintaining a healthy eating habit, controlling weight, performing a daily physical exercise and consuming recommended medications will help in controlling high blood sugar level.

In case you have a concern or query you can always consult an expert & get answers to your questions!