Health

Diabetic Neuropathy in Pakistani Population

Written by Abeer Danish

Diabetes itself a metabolic disorder but also a root cause of many other diseases. According to International Diabetes Federation in Pakistan 6.9 million of diabetic cases were reported in 2014. The prevalence rate is increasing annually and so the risks of diabetic associated disorders. One of the main complicating and troublesome risk is of diabetic neuropathy. This neurological disorder is mostly belongs to elderly age diabetic patients and mostly females in it.

Diabetic neuropathy is actually nerve damage due to hyperglycaemic condition. The key pathogenetic mechanisms of diabetic neuropathy involve increased Androgen receptor activity, oxidative- nitrosative stress, protein kinase C, neurotrophism impairment and C-peptide deficiency. But still so far these mechanisms are poorly understood. To understand these mechanisms experimental rats are used but they also had some serious limitations because of their limited life span, absence of the effects of demyelination and fibre loss and most importantly quantification of pain is difficult.

Neuropathy affect throughout the body. Its classification is based on the parts of body it involves.

Classification taken from jpma.org.pk

Classification taken from jpma.org.pk

The symptoms which indicate the onset of this neuropathy are:

  • numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers, wasting of the muscles of the feet or hands
  • indigestion, nausea, or vomiting
  • diarrhea or constipation
  • dizziness or faintness due to a drop in blood pressure after standing or sitting up
  • problems with urination

Diagnosis of neuropathic pain is based on patient’s history and clinical examination of pain, loss of sensation or distal autonomic impairment by the help of diagnostic tools i.e. nerve conduction studies, measuring of perception of light and pressure with monofilaments and the biopsy of glabrous skin.

Treatment of this disease depends upon the stage it diagnosed. The line of therapies is summarized as follows.

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But the dark face is that these neurotherpeutics have insufficient efficacy, adverse effects and unaffordable to a middle class family of our population. So, novel therapeutic strategies should be developed and further researches is required to exploit puerarin therapeutic activity.

In Pakistan where basic needs are difficult to meet and smallest fraction of budget is invested on education and hospital sector that’s why people also neglect their health status. Irony is that there is a lack of data on the diabetes which required more research work. Keeping in mind that “Health is Wealth”, the main thing we can do is to create awareness and educate our youth to develop healthy lifestyle which eliminate the risk of developing diabetes. Secondly if diabetes has developed, so one should take care of his health, more emphasis on his diet and exercise, daily monitoring of insulin level and monthly checkups should be done. Smoking should be prohibited. Proper maintenance of hygiene avoids the risk of ulceration and amputations. Live your life to the fullest by maintaining your good health.

 

REFERENCES:

  • Peltier, Amanda, Stephen A. Goutman, and Brian C. Callaghan. “Painful diabetic neuropathy.” BmJ 348 (2014).
  • Obrosova, Irina G. “Diabetic painful and insensate neuropathy: pathogenesis and potential treatments.” Neurotherapeutics4 (2009): 638-647.
  • International Diabetes Federation. N.p., 2014. Web. 2015.
  • Liu, Ming, et al. “Puerarin alleviates neuropathic pain by inhibiting neuroinflammation in spinal cord.” Mediators of inflammation 2014 (2014).
  • Gupta A, Gupta Y. Diabetic Neuropathy: Part 1. J Pak Med Assoc. 2014; 64(6): 714-718
  • Amir Aslam, Jaipaul Singh, and Satyan Rajbhandari, “Pathogenesis of Painful Diabetic Neuropathy,” Pain Research and Treatment, vol. 2014, Article ID 412041, 7 pages, 2014. doi:10.1155/2014/412041
  • http://www.niddk.nih.gov/health-information/health-topics/Diabetes/diabetic-neuropathies-nerve-damage-diabetes/Pages/diabetic-neuropathies-nerve-damage.aspx

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Abeer Danish