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INTERNAL MEDICINE ASSIGNMENT

SALSABIL BAHER --- 211009504
GROUP B
Cranial nerve affections of diabetes mellites
Introduction
There are many health
complications that may come
along with diabetes mellites.
These health issues could
range from gum disease to
kidney problems to nerve
damage.
Neuropathy is one of the long-
term complications of diabetes. It can affect different types of
nerves in the body including the feet, muscles and organs.
Diabetic neuropathy can also be extremely painful, patients may
feel tingling, a burning sensation or even shoots of pain.

Types of diabetic neuropathy and its symptoms

Diabetic neuropathy can be

classified into 4 types which
are:

Peripheral neuropathy

This type of neuropathy may also be called distal symmetric

peripheral neuropathy. It's the most common type of diabetic
neuropathy. It affects the feet and legs first, followed by the hands
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and arms. Signs and symptoms of peripheral neuropathy are often

worse at night, and may include:

 Numbness or reduced
ability to feel pain or
temperature changes.
 Sharp pains or cramps
 Muscle weakness
 Extreme sensitivity to touch
— for some people, even a
bedsheet's weight can be
painful.
 Serious foot problems, such
as ulcers, infections, and
bone and joint damage

Autonomic neuropathy

The autonomic nervous system controls blood pressure, heart rate,

sweating, eyes, bladder, digestive system and sex organs. Diabetes
can affect nerves in any of these areas, possibly causing signs and
symptoms including:

 A lack of awareness that blood

sugar levels are low
(hypoglycemia unawareness)
 Drops in blood pressure when
rising from sitting or lying
down that may cause dizziness
or fainting.
 Bladder or bowel problem
 Increased or decreased
sweating
 Persistent nausea and vomiting

Proximal neuropathy
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This type of neuropathy often affects nerves

in the thighs, hips, buttocks or legs. It can
also affect the abdominal and chest area.
Symptoms are usually on one side of the
body but may spread to the other side.
Proximal neuropathy may include:

 Severe pain in the buttock, hip or

thigh
 Weak and shrinking thigh muscles
 Difficulty rising from a sitting position
 Chest or abdominal wall pain

Mononeuropathy (focal neuropathy)

Mononeuropathy refers to damage to a single, specific nerve. The

nerve may be in the face, torso, arm or leg. Mononeuropathy may
lead to:

 Difficulty focusing or double

vision.
 Paralysis on one side of the
face
 Numbness or tingling in the
hand or fingers.
 Pain in the shin or foot

Causes

The exact cause of each type of neuropathy is unknown.

Researchers think that over time, uncontrolled high blood sugar
damages nerves and interferes with their ability to send signals,
leading to diabetic neuropathy. High blood sugar also weakens the
walls of the capillaries that supply the nerves with oxygen and
nutrients. Therefore, this can cause harm to different parts of the
body depending on the type of nerve that has been affected.
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Complications
Diabetic neuropathy can cause several serious complications,
including:

 Hypoglycemia unawareness. Usually

cause shakiness, sweating and a fast
heartbeat. But people who have
autonomic neuropathy may not
experience these warning signs.

 Loss of a toe, foot or leg. In severe cases, an infection can

spread to the bone or lead to tissue death. Removal of a toe,
foot or even part of the leg may be necessary.

 Urinary tract infections If the nerves that control the bladder

are damaged, the bladder may not empty completely when
urinating. Bacteria can build up in the bladder and kidneys,
causing urinary tract infections.

 Sharp drops in blood pressure. Damage to the nerves that

control blood flow can affect the body's ability to adjust blood
pressure. Which may lead to lightheadedness and fainting.

 Digestive problems. Diabetes-related nerve damage can lead

to gastroparesis, a condition in which the stomach empties too
slowly or not at all. This can cause bloating and indigestion.

 Increased or decreased sweating. Nerve damage can disrupt

how the sweat glands work and make it difficult for the body
to control its temperature properly.
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Prevention

Diabetic neuropathy can be delayed or

prevented by closely managing blood sugar
levels and blood fat levels
(cholesterol).And by also proper foot care.

References

https://www.hopkinsmedicine.org/health/conditions-and-diseases/
diabetes/diabetic-neuropathy-nerve-problems

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613403/

https://www.webmd.com/diabetes/diabetes-neuropathy

https://www.mayoclinic.org/diseases-conditions/diabetic-
neuropathy/symptoms-causes/syc-20371580

https://medlineplus.gov/ency/article/000692.htm#:~:text=Cranial
%20mononeuropathy%20III%20is%20the,who%20don't%20have
%20diabetes.