Globally, The number of patients with diabetes is increasing rapidly. By the year 2035, the number of people with diabetes worldwide is expected to rise to 592 million (IDF ATLAS 20131). Diabetic peripheral neuropathy (DPN) is a common microvascular complication of diabetes and a leading cause to amputations in hospitals (Boulton 20052). The prevalence of DPN is estimated to be 50-60% (Sandireddy R 20143). The pain associated with DPN can affect the patient quality of life (QOL). It affects their sleep, lifestyle, work and even can cause or be associated with depression (Jensen MP 20074). It is not well understood whether the mechanism behind peripheral neuropathy with diabetes is hyperglycemia or other insulting pathophysiological mechanism like proinflamatory immune mediators (Herder C 20135, Goh S-Y 20086). One of the possible mechanisms is the demyelination of the small C fiber, this is the leading cause behind the pain sensation with …show more content…
Prevention and slowing the progression of DPN via glucose control has been demonstrated to be effective in patients with type 1 diabetes, but may not be as effective in patients with type 2 diabetes (Callaghan BC 201211). Other studies found no correlation between glycated hemoglobin (HbA1C) with mean of 6.9% and the severity of DPN (Owolabi MO 201212). Diabetic patients are more susceptible to dyslipidemia and metabolic syndrome. Those patients have body mass index (BMI) ≥30Kg/m2, abnormal glucose metabolism with insulin resistance, high low-density-lipoprotein (LDL), total cholesterol (TC), triglycerides (TG), and low high-density lipoprotein (HDL). Those abnormal findings expose patients to atherosclerotic changes and microvascular complications together with hypertension and cardiovascular diseases (Mooradian AD
Why do we treat diabetes? There are a number of downstream events associated with abnormal blood glucose levels. If glucose levels are managed properly, the complications associated diabetes can be controlled, and sometimes completely prevented. The main problem with having more than the normal amount of glucose circulating in the blood stream is the effect that excess glucose can have on both large and small blood vessels (DTC, 2004). Micro-vascular and macro-vascular problems associated with diabetes can be seen in the heart, eyes, kidney, legs and feet. Diabetic patients are twice as likely to suffer from a mycocardial infaraction, twenty-five times more likely to suffer blindness, and seventeen times more likely to suffer kidney failure compared to a non-diabetic (DTC, 2004). Because of great number of risks associated with abnormal blood glucose levels, diabetes is aggressively treated to improve the quality of life and prevent complications in patients.
Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.
Why are nerves often damaged in patients with diabetes mellitus, and what are some of the
The American Diabetes Association (2004) defines diabetes as a subset of metabolic diseases associated with hyperglycemia secondary to insulin failing to release, act, or both. Complications related to chronic diabetes can be detrimental to one’s health including but not limited to: heart disease, stroke, kidney disease, amputations, blindness, and other optical diseases. Furthermore, the prevalence of diabetes is rising at an astronomical rate within the United States as well as internationally. According to the Center for Disease Control and Prevention (CDC) (2016) an estimated 29 million people suffer with diabetes and 86 million are prediabetic within the United States (US). Without major interventions from the healthcare community,
Diabetes mellitus (DM) is a pandemic that affects millions of people. The growth rate of unrecognized pre-diabetes in America is expected to rise up to 52% by 2020 (Lorenzo, 2013). As the prevalence of diabetes increases, so will the complications and burden of the disease. One of the leading causes for cardiovascular disease, renal failure, nontraumatic lower limb amputations, stroke, and new cases of blindness is DM (Lorenzo, 2013).
Uncontrolled diabetes can affect nearly every organ of the body; of which, heart disease and kidney failure are most commonly impacted. Known as diabetes mellitus, a collective term for various blood abnormalities, the term diabetes refers to either a scarcity of insulin in the body or the body’s inability to accept insulin. Though the symptoms of diabetes are manageable, many are unaware as to having it. According to the CDC report “2011 Diabetes Fact Sheet,” approximately 6 million people in the United States have undiagnosed diabetes. Undetected, diabetes can become deadly. In a recent World Health Organization report “Diabetes Action Now: An Initiative of the World Health Organization and the International Diabetes Federation,” it
The increase in the prevalence of type 2 diabetes is causing huge health problem through out the world including developed countries. Mostly people with low income groups are affected in developed countries (Zimmet 2001).The magnitude of the healthcare problem of type 2 diabetes results mainly from its association with obesity and cardiovascular risk factors. Indeed, type 2 diabetes has now been identified as one manifestation of the “metabolic syndrome”, a condition characterised by insulin resistance and associated with a range of cardiovascular factors (Jonathan 2003)
Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while
However, because Danny does have diabetes, his health is in a poorer state and his risk for developing cardiovascular disease is increased. Diabetes is defined as having a fasting plasma glucose value of 7.0 mmol/l (126 mg/dl) or higher. Every year, diabetes claims many lives; for example, in 2008, diabetes was responsible for 1.3 million deaths all across the world (World Heart Federation, N.p., n.d). When looking at cardiovascular disease with diabetes, data shows that of all diabetics who die, 60% of them die as a result of cardiovascular disease (World Heart Federation, N.p., n.d). Cardiovascular risk increases with raised glucose values. The risk of cardiovascular events is from two to three times higher in people with type 1 or type 2 diabetes and the risk is disproportionately higher in women (World Heart Federation, N.p., n.d). From this we can infer that if my mother or I did have diabetes, it would be likely that that would increase our risk to a greater degree compared to Danny’s risk, because he is a male. Cardiovascular risk increases with raised glucose values. In addition, within certain age groups, people with diabetes have a two-fold increase in the risk of stroke. Patients with diabetes also have a poorer prognosis after cardiovascular events compared to people without diabetes. Primary care access to measurement of blood glucose and cardiovascular risk assessment as well as
Type-2 Diabetes mellitus (T2DM) is a common disease worldwide. According to the American Diabetes association (ADA), 1808 million people in the United States have been diagnosed with diabetes, and another 7 million are thought to have the disease but have not been diagnosed. (Hilaire, Woods, 2013). This disease has impacted everyone in some way. It is a controllable disease; however many individuals choose not to control it or are uneducated on how to control it. Many people with type 2 diabetes (T2DM) also have hypertension, high cholesterol, obesity, lack of physical activity, poorly controlled blood sugars, and smoking. “Current evidence supports the concept that hyperglycemia significantly contributes to the development of both cardiovascular and microvascular complications of T2DM” (Chittari, McTernan, 2011). Cardiovascular disease (CVD) remains the leading cause of death in patients with diabetes mellitus, accounting for 50% of all deaths (Campbell & Hillman, 2010).
Among U.S. adults aged 20 years or older with diagnosed diabetes, the estimated crude prevalence of
Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)
Chronic pain is any pain that lasts longer than 3 months (FNLM, 2011). A common type of chronic pain is neuropathic pain which occurs when the nerves themselves are damaged by injury or disease (Veteran Mates, 2013). Neuropathic pain is a complex condition that is often underdiagnosed or undertreated, resulting in negative physical, psychological and social impacts (Veteran Mates, 2013). Therefore early management is critical in order to improve the person’s quality of life and to reduce the chance of the pain becoming persistent (Pain Health, 2015). The following 5 articles relating to the management of neuropathic pain will be annotated, including a summary of the main
Glucose fluctuations has been suggested as a main contributor to both micro and macrovascular complications, therefore tight glycaemic control was fought to benefit in patients with type diabetes mellitus. However, individual results from tree recent clinical trials—the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE trial), and the Veterans Affairs Diabetes Trial (VADT) failed to support a significant reduction in CVD events in the intensive glycaemic groups (Buse et al., 2007; Patel et al., 2008; Duckworth et al., 2009). In fact, in those studies intensive glucose control may increase risk in older patients with pre-existing CHD or longer duration of diabetes.
There is growing concern that intense glucose lowering or the use of certain agents may be associated with adverse cardiovascular outcomes.