Diabetic neuropathy is a very prominent and common complication to be found in diabetes. According to a United States-based study, the prevalence of diabetic nephropathy is suspected to be about 50% with nearly 10% of the cases presenting after the onset of neuropathy without the previously known diagnosis. The sensory type of neuropathy is more common than any of other types. Type 2 diabetes is found to have more prevalence of diabetic neuropathy than in type 1 diabetes. No racial or sexual predilection has been found in the causation of diabetic neuropathy.[1]

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What Is The Prognosis For Diabetic Neuropathy?

The prognosis of diabetes-related complications depends largely upon the history of glycemic control of the patient. Diabetic neuropathy shows higher morbidity and mortality rates when left untreated or patient doesn't stick to the strict glycemic control. Inadequate treatment or skipping of the medication also precipitates the complications and make the prognosis poorer. In cases of a sensory type of neuropathy, repetitive trauma occurring on the periphery of limbs due to the absence of sensations is very dangerous and can be even life-threatening. Since the blood supply is also in peripheral areas, it becomes very difficult for the healing of even life-threatening drama and can form large ulcers or diabetic foot which have very poor prognosis like amputation of the limb or even death can occur.

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In cases of an autonomic type of neuropathy, the cardiovascular system involvement has the poorest prognosis among all the other systems if involved in it. According to data analysis, the mortality rate was found to be about 20 to 30% in cases of cardiovascular involvement when compared to 5% in cases sparing the cardiovascular system. Trauma incidence due to syncope and orthostatic hypotension has increased over the years due to the rise of autonomic diabetic neuropathy. Such patients are also suffering from other complications like diabetic retinopathy or diabetic nephropathy due to the microangiopathic changes occurring in the body. Overall the prognosis of diabetic neuropathy remains poor because it shows that the disease has already progressed to dangerous stages.

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Lifestyle Changes For Diabetic Neuropathy

Dietary changes and nutritional restriction are the mainstays of lifestyle changes required to be done to reduce the chances of diabetic neuropathy. Carbohydrate and fat intake should be regulated strictly according to the advice of the doctor or the nutritionist.[2] Weight reduction and exercise are the things to be incorporated in lifestyle for maintaining a strict glycemic control. Extreme conditions like hot weather or snow should because the patient is unable to feel the effects of such weather and can suffer from a dangerous event in such a situation. Patients should remain active and increase in daily routine activities should be done to prevent muscle wasting and atrophy. Proper care of the extremities especially the feet should be done and getting even a trivial trauma should be avoided as it is very difficult to heal on the feet due to the poor blood supply.

Conclusion

Diabetic neuropathy itself represents a later stage of the disease and is encountered usually after 15 to 20 years of the known case of diabetes mellitus. It not only has a poor prognosis in the treatment but also show shows a high mortality rate among the total number of cases of neuropathy. If the neuropathy comes earlier, it means the progression has become fast and prognosis has fallen towards the poorer side. Ignoring the symptoms and the treatment is very much dangerous because of its high morbidity and suffering.

Few lifestyle modifications can not only change the progression of the disease but also remit a few of the recent changes. Dietary modification for the consumption of carbohydrates and fats is absolutely necessary for such patients to keep themselves away from the complications of diabetes mellitus. Regular checkups and frequent follow-ups should be done to ensure the adequacy and persistence of the treatment.

References:  

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: August 3, 2019

This article does not provide medical advice. See disclaimer

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