Diabetic Peripheral Neuropathy in Youth

Autor: Joanne T. Moser, David R. Langdon
Rok vydání: 2013
Předmět:
Zdroj: Journal of Pediatric Nursing. 28:415-417
ISSN: 0882-5963
Popis: Neuropathy is a common long-term complication of diabetes recognized almost entirely in adults (Moser et al., 2013). It is a precursor to foot ulcers and lower limb amputations, both of which are preventable (Fletcher, 2006; Zangaro & Margaret, 1999). The pathogenesis of diabetic peripheral neuropathy (DPN) is not completely understood. Evidence suggests that hyperglycemia and other metabolic factors contribute to nerve damage, at least in part by degrading the function of small blood vessels supplying the nerves, resulting in progressive structural deterioration of nerve pathways (Trotta, Verrotti, Salladini, & Chiarelli, 2004). Hyperglycemia may disrupt myelin nerve sheaths, causing motor nerve conduction slowing and impaired sensory perception. For many years it was believed that DPN was simply a condition that develops after years of diabetes and directly related to the degree of blood sugar control (Glastras, Mohsin, & Donaghue, 2005). However, there is accumulating evidence suggestive of subclinical changes of nerve function shortly after diagnosis even in children. In addition to hyperglycemia, there are other factors that may contribute to an increased risk of symptomatic or asymptomatic neuropathy including taller stature, elevated lipids, smoking, elevated diastolic blood pressure, puberty and autoimmunity (Donaghue & Silink, 1999; Spollett, 2006; Su et al., 2012; Trotta et al., 2004). The clinical effects of this sensory neuropathy include painful burning and tingling sensations that can progress to numbness and eventual loss of protective sensation in the feet. This loss of sensation renders the feet vulnerable to unsuspected trauma, infection, and eventually ulceration (National Diabetes Education Program, 2000). The risk of lower limb amputation increases substantially with repeated
Databáze: OpenAIRE
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