The improvement of living standards has made the trend of younger diabetes more and more obvious. Diabetes mellitus is prone to many complications, especially in patients with a long medical history, if there is pain at the end of the limbs, especially in the lower limbs, or the feet have the feeling of stepping on cotton, the foot wound is not easy to heal, and the foot begins to turn black and necrotic from the end, it is necessary to be alert that this is caused by diabetic peripheral neuropathy.
Recently, Chief Physician Guo Yanwu, Director of the Department of Functional Neurosurgery of Zhujiang Hospital of Southern Medical University, and Lin Xin, the gold medal host of the national health program, co-organized by the Zhong Nanshan Medical Foundation of Guangdong Province, had an in-depth discussion with the majority of netizens on the early intervention of diabetic peripheral neuropathy in the live broadcast room of the medical federation media.
Chief Physician Guo Yanwu (right)
Diabetic peripheral neuropathy is irreversible and alert to typical symptoms
As a common chronic complication of diabetes, diabetic peripheral neuropathy is not only an important risk factor for diabetic foot and diabetic foot ulcers, but also an important factor for falls and fractures. Once diabetic peripheral neuropathy develops, it cannot be reversed and can only relieve symptoms. If you don't get treatment in time, a series of changes will occur later. To this end, Chief Physician Guo Yanwu reminds diabetic patients to pay attention to the following points:
1. Diabetic peripheral neuropathy (DPN) is generally manifested as symmetrical multiple sensory neuropathy, which initially affects the distal lower limbs, and gradually develops to the proximal end as the disease progresses, forming a typical "sock-like" and "glove-like" sensation.
2. The most common symptoms are pain and paresthesia (caused by small fibrous lesions), which can be manifested as burning, electric shock pain and sharp pain, as well as soreness, itching, cold pain and induced pain, numbness and abnormal position sensation (caused by large fibrous lesions).
3. Up to 50% of DPNs may be asymptomatic, and patients are at increased risk of foot injuries if they are not identified and preventive foot care is not implemented.
If the blood sugar is normal, it is also necessary to guard against lesions, and the sooner the preventive intervention, the better
During the live broadcast, some netizens asked why complications still occur when blood sugar is measured normally every day? Chief Physician Guo Yanwu replied that diabetes is not only a problem of blood sugar, especially for type 2 diabetes, blood sugar control is only the first measure, and at the same time, it is necessary to quit smoking, manage blood lipids, blood pressure, weight, etc., these are all risk factors for diabetic peripheral neuropathy. Therefore, in patients with prediabetes, metabolic syndrome, and type 2 diabetes, lifestyle interventions are recommended to prevent the development of DPN, and the earlier the intervention, the better the effect, generally including the following:
1. Self-management: Regular nutrition counseling to improve blood sugar control
2. Eat regularly: Don't eat a full meal and be hungry, add meals reasonably to promote postprandial blood sugar stability
3. Diet: Combined with traditional Chinese medicine, dietary supplementation also plays a certain role in diabetic diet
4. Light diet: avoid big fish and meat, limit alcohol consumption, prevent and delay complications
5. Diverse food: Don't eat only a few fixed foods every day, develop and establish reasonable dietary habits
6. Appropriate energy: energy should not be too much or too little, control overweight and obesity and prevent weight loss
7. Staple food ration: Whole grains and low glycemic index foods are preferred, such as tofu, meat, etc
8. Active exercise: improve physical fitness and insulin sensitivity, and also lose weight
Minimally invasive surgery has a significant effect, relieves pain and improves blood circulation
For diabetic patients who do not respond to interventional therapy, or whose conditions are not suitable for open surgery, spinal cord stimulation therapy (SCS) can be selected, which can not only effectively relieve ischemic pain, but also improve the wound healing of lesions, which is an effective supplement to vascular reconstruction, and the establishment of microcirculation in the lower limb of the knee, SCS is the only effective method, and its advantages lie in minimally invasive and reversible in part of the situation.
Chief Physician Guo Yanwu added that it should be reminded that spinal cord stimulation therapy also has the best intervention time window, which is generally before Wagner grade 3, that is, some parts of the patient's feet are not rotten, but there is very obvious ischemic pain. With this treatment, the patient's peripheral circulation is immediately improved, and the pain sensation is significantly relieved, helping to prevent further deterioration of the diabetic foot. Of course, the sooner this intervention is used, the better the treatment will be.
Diabetic patients have a higher chance of developing diabetic peripheral neuropathy, especially those with type 2 diabetes, in addition to controlling blood sugar, lifestyle improvement is also an important means of early intervention. If something unfortunate still happens, the patient should go to the hospital for treatment as soon as possible, and in addition to the use of conventional medications, timely surgical intervention can also improve the overall level of treatment.
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