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Where to Find the Help You Need!
People who notice signs and symptoms that we have talked about here should not wait to see what is going to develope. As much as you would like, chances are that if your neuropathy is chronic,it's not going to go away on its own. Instead the longer you wait before seeking help the chances for treatments being sucessful are a lot less.
Some neuropathies develope very quickly,but most develope slowly over the years. Get busy right now, even if you don't feel that bad. Initially nerve damage can be mild unless it goes untreated and then it can spread and the damage can be irreversible.
Find a good Doctor. And don't be a passive patient. You don't have to accept a diagnosis that says nothing can be done about your condition. Get second opinions. Inform yourself by reading and doing research about neuropathy. Find support groups in your area or via the internet. There are over two million people in this country that have neuropathy in one form or another. Yet it has been called the silent disease because too few people, both patients and doctors are aware of it.
These are a few reasons why people from all over the U.S. have gotten together and formed organization such as The Neuropathy Association,Support groups in areas where people with PN live,Web Page Sites and even E-Mail Pen Pal Lists so they can pull together for the support they need and to make the American Medical Association and the general public more aware of just how many people are suffering from this terrible dibilitating disease.
Diabetes mellitus, commonly referred to as "diabetes," means "sweet urine." It is a chronic medical condition associated with abnormally high levels of sugar (glucose) in the blood. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine. Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes mellitus, the absence or insufficient production of insulin causes hyperglycemia. Diabetes mellitus is a chronic medical condition, meaning it can last a life time. Over time, diabetes mellitus can lead to blindness, kidney failure, and nerve damage. Diabetes mellitus is also an important factor in accelerating the hardening and narrowing of the arteries (atherosclerosis), leading to strokes, coronary heart diseases, and other blood vessel diseases in the body.
Diabetes mellitus affects 12 million people (6% of the population) in the United States. The direct and indirect cost of diabetes mellitus is $40 billion per year. It is the third leading cause of death in the United States after heart disease and cancer.
The lack of insulin, insufficient production of insulin, production of defective insulin, or the inability of cells to use insulin leads to hyperglycemia and diabetes mellitus. Glucose is a simple sugar found in food. Glucose is an essential nutrient that provides energy for the proper functioning of the body cells. After meals, food is digested in the stomach and the intestines. The glucose in digested food is absorbed by the intestinal cells into the bloodstream, and is carried by blood to all the cells in the body. However, glucose cannot enter the cells alone. It needs assistance from insulin to penetrate the cell walls. Without insulin, cells become starved of glucose energy despite the presence of abundant glucose in the blood. In diabetes mellitus, the cells' inability to utilize glucose gives rise to the ironic situation of "starvation in the midst of plenty." The abundant, unutilized glucose is wastefully excreted in the urine.
Insulin is a hormone which is produced by specialized cells (islet cells) of the pancreas. In addition to helping glucose enter the cells, insulin is also important in tightly regulating the level of glucose in the blood. The pancreas is a deep seated organ in the abdomen located behind the stomach. After a meal, the blood glucose level rises. In response to the increased glucose level, the pancreas normally releases insulin into the bloodstream to help glucose enter the cells and lower blood glucose levels. When the blood glucose levels are lowered, the insulin release from the pancreas is turned off. In normal individuals, such a regulatory system helps to keep blood glucose levels in a tightly controlled range. In patients with diabetes mellitus, the insulin is either missing (as in type I diabetes mellitus), or insulin regulation is defective and insufficient (as in type II diabetes mellitus). Both cause elevated levels of blood glucose (hyperglycemia).
There are two major types of diabetes mellitus, called type I and type II. Type I diabetes mellitus is also called insulin dependent diabetes mellitus (IDDM), or juvenile onset diabetes mellitus. In type I diabetes mellitus, the pancreas releases no insulin at all, and the patient relies on insulin medication for survival. Abnormal antibodies have been found in patients with IDDM. Antibodies are proteins in the blood that are part of the body's immune system. Normally, the immune system is designed to protect the body against foreign invaders and infections. In autoimmune diseases, such as IDDM, the immune system mistakenly manufactures antibodies that are directed against and cause damage to patients' own body tissues. It is believed that the tendency to develop these abnormal antibodies in IDDM is genetically inherited. The gene for developing IDDM has been identified on chromosome number 11. (Chromosomes are cellular DNAs where all genetic information is stored.) Exposure to certain viral infections (mumps and Coxsackie viruses) or other environmental toxins may serve to trigger abnormal antibody responses that cause damage to the pancreas cells where insulin is made. Type I diabetes tends to occur in young, lean individuals, usually before 30 years of age. Approximately 10% of the patients with diabetes mellitus have IDDM; the remaining 90% have type II diabetes mellitus.
Type II diabetes mellitus is also referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult onset diabetes mellitus (AODM). In type II diabetes, patients can still produce insulin, but do so inadequately. The pancreas in these patients not only produces an insufficient amount of insulin, but also releases insulin late in response to increased glucose levels. Some type II diabetics have body cells that are resistant to the action of insulin. Finally, the liver in these patients continues to produce glucose despite elevated glucose levels. Type II diabetes mellitus occurs mostly in individuals over 40 years old, and is also known as adult onset diabetes mellitus. The incidence of type II diabetes increases with age. Unlike type I diabetes mellitus, the majority of type II diabetic patients are obese. Type II diabetes mellitus also has a strong genetic tendency.
Diabetes mellitus can occur transiently during pregnancy. Significant hormonal changes during pregnancy can lead to blood sugar elevation in genetically predisposed individuals. Blood sugar elevation during pregnancy is called gestational diabetes. Gestational diabetes usually resolves once the baby is born. However, 50% of women with gestational diabetes will eventually develop diabetes mellitus later in life, especially in those who require insulin during pregnancy.
" Secondary" diabetes mellitus refers to elevated blood sugar levels from another medical condition. Secondary diabetes mellitus also develops when the pancreatic tissue responsible for the production of insulin is absent because it is destroyed by disease, such as chronic pancreatitis (inflammation of the pancreas by toxins like excessive alcohol), trauma, or surgical removal of the pancreas. Diabetes can also result from other hormonal disturbances, such as excessive growth hormone production (acromegaly) and Cushing's syndrome. In acromegaly, a pituitary gland tumor at the base of the brain causes excessive production of growth hormone, leading to hyperglycemia. In Cushing's syndrome, the adrenal glands produce an excess of cortisol, which promotes blood sugar elevation.
The normal blood glucose level after an overnight fast is less than 120 mg/dl. The diagnosis of diabetes mellitus is made when an overnight fasting blood glucose is greater than 140 mg/dl on two different occasions. If the fasting blood glucose is between 120 to 140 mg/dl, a glucose tolerance test can be done in patients suspected of having diabetes mellitus. 75 grams of glucose, usually in the form of a cola drink, are given by mouth and blood samples to detect glucose levels are obtained before the drink, and at 30 minutes, 60 minutes, 90 minutes, and 2 hours afterwards. In patients with diabetes, blood glucose levels are abnormally elevated during this test.
Insulin is vital to patients with type I diabetes. Without insulin, patients with type I diabetes can develop severely elevated blood sugar levels. This leads to increased urine glucose, which in turn leads to excessive loss of fluid and electrolytes in the urine. Lack of insulin also causes the breakdown of fat cells, with the release of ketones into the blood. Ketones turn the blood acidic, a condition called diabetic ketoacidosis. Symptoms of diabetic ketoacidosis include nausea, vomiting, and abdominal pain. Without prompt medical treatment, patients with diabetic acidosis can rapidly go into shock, coma, and even death. Diabetic ketoacidosis can be precipitated by infections, stress, or trauma. Urgent treatment of diabetic ketoacidosis involves the intravenous administration of fluid, electrolytes, and insulin, usually in a hospital intensive care unit. Antibiotics are given for infections. With treatment, abnormal blood sugar levels, acidosis, and dehydration can be reversed rapidly, and patients can recover remarkably well.
In patients with type II diabetes mellitus, stress, infection, and medications (such as corticosteroids) can also lead to severely elevated blood sugar levels. Accompanied by dehydration, severe blood sugar elevation in patients with type II diabetes mellitus can lead to an increase in blood osmolality (hyperosmolar state). This condition results from the presence of too many molecules in the blood because of the increased blood sugar. A hyperosmolar state in the blood can lead to coma (hyperosmolar coma). A hyperosmolar coma usually occurs in elderly patients with type II diabetes mellitus. Like diabetic ketoacidosis, a hyperosmolar coma is a medical emergency. Immediate treatment with intravenous fluid and insulin is important in reversing the hyperosmolar state. Unlike patients with type I diabetes mellitus, patients with type II diabetes mellitus do not generally develop ketoacidosis. Likewise, patients with type I diabetes mellitus do not usually develop a hyperosmolar state.
Hypoglycemia means abnormally low blood sugar (glucose). In patients with diabetes, the most common cause of low blood sugar is excessive use of insulin medication or other glucose-lowering medications, such as those taken by mouth to lower the blood sugar level in diabetic patients. When low blood sugar levels occur because of too much insulin, it is called an insulin reaction. Sometimes, low blood sugar can be the result of an insufficient caloric intake or sudden excessive physical exertion. Blood glucose is essential for the proper functioning of nerve cells in the brain. Therefore, low blood sugar can lead to nervous system symptoms such as dizziness, confusion, weakness, and tremors. Untreated, severely low blood sugar levels can lead to coma and irreversible brain death. The treatment of low blood sugar consists of administering glucose drinks, such as orange juice, soft drinks (not sugar-free), or glucose tablets. If the individual becomes unconscious, glucagon can be given by intramuscular injection. Glucagon causes the release of glucose from the liver, and should be part of the emergency kit of a diabetic, especially if the patient uses insulin.
The long term complications of diabetes mellitus are more common in patients with type I diabetes than in patients with type II diabetes. These complications are related to blood vessel diseases. Diabetes causes diseases of the small vessels which can damage the eyes, kidneys, and nerves. Diabetes also accelerates hardening of the arteries (atherosclerosis) of the larger blood vessels, leading to coronary heart disease (angina or heart attack), strokes, and pain in the lower extremities because of lack of blood supply (claudication).
Links to other sites on the Web
Peripheral Neuropathy,Info Diabetes Treatment , Vitamins Beautiful Lake Applets and Poetry Our Best Friends Link Marys Diabetes Page
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