In keeping with National Diabetes month, The Aging Suite will be discussing diabetic neuropathy this week.  Diabetic Neuropathy can occur in all of the body’s organs, impacting the way in which individuals function safely in their homes. This impact can be due to issues such as sensation and vision loss as well as muscle weakness.  By educating our readers about diabetes’ effects on the body, we hope to continue in our efforts to help the elderly population successfully age in place.

It’s estimated that 60 to 70 percent of people with diabetes have diabetic neuropathy.  Diabetic neuropathy, nerve damage caused by diabetes, can occur in all of the body’s organ systems.  The cause of the nerve damage can be due to several factors such as:

• High blood glucose levels
• Abnormal blood fat levels
• Nerve inflammation
• Low insulin levels
• Smoking or alcohol use

Risk Factors for Diabetic Neuropathy include:

• Being overweight
• Being a diabetic for a long time period
• Diabetics who have a difficult time controlling their blood sugar
• Diabetics who have high levels of blood fat
• Diabetics with high blood pressure

There are 4 classifications of Diabetic Neuropathies; they are, peripheral, autonomic, proximal, and focal.

Peripheral Neuropathies
This is the most common type of diabetic neuropathy and is nerve damage in the arms, hands, legs, and feet.  Symptoms include:

• Numbness or tingling
• Pain and cramps
• Loss of balance
• Muscle weakness

Autonomic Neuropathies affect the eyes, heart, lungs, kidneys, sex organs, as well as the urinary, respiratory, and digestive systems.  Symptoms include:

• Hypotension
• Being unaware when your blood sugar levels drop
• Constipation
• Nausea and vomiting
• Diarrhea
• Urinary tract infections
• Urinary incontinence
• Erectile dysfunction

Proximal Neuropathies are more common among older diabetics and individuals with type II diabetes.  This type of neuropathy initially starts off as pain in the legs, thighs, buttocks, or hips.  Proximal neuropathies cause leg weakness, resulting in mobility issues.

Focal Neuropathies are unpredictable and can cause severe pain.  It often impacts nerves in the legs, head, and trunk.  This type of neuropathy occurs more often in older adults and can cause:

• Double vision
• Pain in the lower back and pelvis area
• Thigh pain
• Chest or abdominal pain
• Bell’s palsy

Diabetic Neuropathies can be prevented by managing your blood sugar levels and keeping them to a normal or as close to normal as possible range.   Diabetic foot care is also essential.  Sores and ulcers can lead to infection.  Diabetic neuropathies that cause pain may be treated with pain medications.  For those who experience urinary tract infections, they may be treated with antibiotics.  Your physician may prescribe occupational and physical therapy to address muscle weakness.  Check out this week’s technology in the Suite to learn more about diabetic foot care.

Source:   National Institutes of Health

Continuing our special November series during National Diabetes Month, this week, The Aging Suite discusses End Stage Renal Disease (ESRD).  Diabetes is the most common cause of ESRD and ESRD impacts all of the body’s major organs.

ESRD occurs when there is permanent failure of the kidneys meaning the kidneys no longer having the ability to regulate electrolytes, remove waste, and concentrate urine.

ESRD may occur after a person has suffered chronic kidney failure (which may span over a period of one to two decades).  Treatment for the disease includes dialysis or a kidney transplant.  Additionally, individuals may be placed on a restricted diet and be given medications to increase their urine output.

Symptoms of ESRD vary and may include:

• Fatigue
• Decreased muscle strength
• Decreased fine motor coordination
• Hypotension
• Decreased joint range
• A temporary loss of consciousness
• Loss of sensation
• Visual loss and decreased visual acuity
• Peripheral neuropathy such as tremors or foot drop
• Changes in mental status such as drowsiness and decreased attention span

With all the possible symptoms and complications related to ESRD home safety issues may be of particular concern for the individual with ESRD and their family members/caregivers.  Simple things such as using a grab bar  and tub bench/bath stool may be beneficial.  Click here to learn more about fall prevention.

Source: Medline Plus and Emedicine

A major part of aging in place is living in your home safely and independently.  Diabetes can impact your independence, but you can limit its impact.  Education is key.  Continuing with our month long series on diabetes, The Aging Suite will be discussing blood pressure’s impact on diabetes.

Atherosclerosis occurs when deposits of fats, cholesterol, calcium, and other substances build up in the arteries and cause a plaque buildup in the lining of the artery.  High blood pressure, high cholesterol and diabetes can contribute to atherosclerosis. A diabetic is at increased risk for developing high blood pressure and other cardiovascular problems. In fact, it’s estimated that 60% of people with diabetes have high blood pressure.  So, for someone with diabetes, monitoring your blood pressure is crucial.

Your blood pressure is recorded as two numbers- the top number is the systolic pressure and the bottom number is the diastolic pressure.  The systolic pressure represents your heart when it‘s pumping, while the diastolic represents when your heart at rest between beats.

Low and High Blood Pressure:

Hypotension, or low blood pressure, occurs when your blood flow is so low that it can’t deliver oxygen to organs such as the brain, heart, and kidneys.  Low blood pressure can be a symptom of end stage renal disease and can cause:

• Dizziness
• Fainting
• Blurry vision
• Weakness
• Being light headed

Hypertension, or high blood pressure, typically does not present with symptoms.  However, individuals suffering from either can experience:

• Headaches
• Blurred vision, and/or
• Dizziness
• Nausea

Recommended blood pressure range for diabetics:

The National Institutes of Health and The American Diabetes Association both recommend that the target blood pressure for someone with diabetes be less than 130/80 mmHG.

Blood pressure can be managed through medications, diet, and exercise.  Manage your blood pressure and help manage your life.  Check out this week’s Technology in the Suite to find out more about technology for individuals with diabetes.

Sources:  WebMD The National Institutes of Health and The American Diabetes Association