Dr. Upendra Mishra

Diabetic neuropathy is a nerve disorder caused by diabetes. The high blood sugar from 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...

1. High blood glucose, a condition associated with diabetes, causes chemical changes in nerves. These changes impair the nerves' ability to transmit signals. 
2. 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.
3. Presence of mechanical injury like carpal tunnel syndrome in a diabetic patient worsens its symptoms and prognosis
4. Inherited traits increase susceptibility to nerve disease
5. 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. In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a gnawing problem that affects millions throughout the world. It is a disorder that if overlooked can lead to serious diseases; cardiovascular ailments, problems related to vision, kidney problems and many more. While medication tries to regulate your blood sugar levels, it is not always unfailing. Medication along with changes in your diet and lifestyle can still not improve your condition in certain cases. At times it is hard to increase the insulin production in a person's body even after administering medicines solely known for their efficacy. Such kind of diabetic patients can therefore benefit from a Bariatric surgery.

What is a Bariatric surgery?

Bariatric surgery doesn't refer to a single operative method. It involves a host of surgical procedures conducted on a person to rid him or her of obesity. Obesity in combination with diabetes can make a person's life miserable. The treatment of one can come in the way of curing the other. A diabetic patient who also suffers from obesity usually finds it hard to lose weight in spite of exercising or being on diet. Surgery comes to their rescue. This kind of surgery should be fallen back upon as the lender of last resort that is to say when other solutions have not helped. Bariatric surgery is always performed under skilled supervision. It might include reduction of the size of your stomach, removal of a portion of the stomach, or even gastric bypass surgery.

How does Bariatric surgery help reduce Diabetes?

Diabetes can be of three basic kinds;

Type 1 diabetes in which the body produces no amount of insulin.

Type 2 diabetes in which the body produces an insufficient amount of insulin or Gestational diabetes that pregnant women tend to contract.

Bariatric surgery proves to be very advantageous for patients of Type 2 diabetes:

1. Surgery lowers blood sugar levels considerably. Research shows people with acute diabetes made huge improvements after having undergone a Bariatric surgery. Their blood sugar levels dropped by a noticeable percentage and they felt healthier. Reduced blood sugar is an almost immediate effect in some while for others it does take some time.

2. Bariatric surgery exercises a control over cholesterol, blood pressure and triglyceride levels.

3. The impressive benefits of this operation for a Type 2 diabetes patient are not superficial or temporary. If the patient adheres to the lifestyle prescribed by a doctor, takes medication regularly and follows the basics of post- operative care he or she is likely to remain beyond the ambit of this metabolic disorder.

4. It successfully takes care of ailments resulting from diabetes.

5. Bariatric surgery can eliminate the need for medication or it can reduce the dosage of medicines you take.           

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