Tuesday, January 15, 2019

La Diabetes y el Daño a los Nervios


El daño a los nervios causado por los niveles altos de azúcar en la sangre por la diabetes, también se conoce como neuropatía diabética. La mayoría de las personas con diabetes sufrirá algo de daño a los nervios, especialmente a medida que envejecen y tienen diabetes por muchos años.

Los problemas a los nervios son más comunes si tiene diabetes y:
• tiene problemas para controlar el azúcar en la sangre; • tiene sobrepeso;
• tiene la presión arterial alta;
• tiene el colesterol alto.

Tipos de daño a los nervios 
Hay varios tipos de daño a los nervios que se pueden dar por la diabetes, pero los dos tipos más comunes son:
Neuropatía periférica que a menudo causa dolor o pérdida de sensación en los dedos de los pies, piernas, manos y brazos. En general los pies y las piernas se ven afectados antes que los brazos y las manos.
• Neuropatía autonómica que causa cambios en la digestión de los alimentos, la función intestinal y de la vejiga, y la respuesta sexual. También puede afectar a los nervios que controlan los vasos del corazón y los sanguíneos, los pulmones y los ojos. Este tipo también está vinculado a lo que se llama conciencia sobre la hipoglicemia, que sucede cuando ya no tiene señales de advertencia de los niveles bajos de azúcar en la sangre.

Prevenga el daño a los nervios
Mantenga sus niveles de azúcar en la sangre dentro de valores saludables. Colabore con su médico y con su equipo de atención de la diabetes para averiguar cómo mantener controlados sus niveles de azúcar en la sangre. Como parte de su atención, su médico debería hacerle un examen de los pies cada año para comprobar si ha perdido algo de sensibilidad en los dedos de los pies o los pies.

Cuidado diario de los pies 
Revísese los pies a diario para ver si tiene piel abierta, llagas o manchas rojas. Puede tener una llaga y no notarla por el daño a los nervios. Si detecta problemas en la piel, hable con su médico.
 • Lávese los pies todos los días con agua tibia y jabón suave. No sumerja sus pies. Séquese bien los pies con una toalla suave. Asegúrese de secarse entre los dedos.
• Compruebe no tener cortes, raspaduras, ampollas, manchas rojas, llagas u otros problemas en los pies y los dedos de los pies. Asegúrese de revisar las partes superior, inferior y los lados de los pies. Mire debajo y alrededor de cada dedo. Tal vez deba usar un espejo o pedirle ayuda a alguien para mirar la parte inferior de los pies.
• Aplíquese loción hidratante en los pies, pero evítela entre los dedos.
• Use una piedra pómez con suavidad para alisar los callos después de una ducha. No se los corte nunca. • Cuando tenga las uñas de los pies largas, córtelas en línea recta y límelas con una lima para suavizar los bordes.
• Use medias limpias y secas que le queden cómodas.
• Use zapatos o zapatillas para proteger los pies. No ande nunca descalzo. Use zapatos que le queden bien y le brinden buen soporte. Mire el interior de sus zapatos antes de ponérselos para asegurarse de que no haya objetos en ellos y de que no tengan roturas, raspones o puntas afiladas.

Señales de daño a los nervios 
Los síntomas varían según los nervios afectados. Algunas personas no tienen absolutamente ninguna señal. Algunas de las señales empeoran con el correr del tiempo y algunas personas informan de que las señales son peores por la noche. Las señales pueden incluir: • Adormecimiento, cosquilleo, pérdida de la sensación o dolor en los dedos de los pies, pies, piernas o dedos, manos y brazos • Pérdida de musculatura en los pies o manos • Náusea y vómitos o problemas de indigestión • Diarrea o estreñimiento • Problemas con el flujo o el control de la orina • Mareos o desmayos al pararse o sentarse que causan una baja en la presión sanguínea llamada hipotensión ortostática • Debilidad • Disfunción eréctil en los hombres o sequedad vaginal en las mujeres • Cambios en el ritmo cardíaco Si tiene alguno de estos síntomas, visite a su médico para un examen médico.

Exámenes 
Su médico lo revisará y le hará preguntas acerca de las señales que pudiera tener. Podrían también ordenársele exámenes como: • Estudio de conducción nerviosa o electromiografía (EMG) que utiliza señales eléctricas para comprobar el estado de los nervios. • Ultrasonido, que usa ondas de sonido para comprobar el estado de los órganos como la vejiga o el estómago.

Tratamiento de los nervios dañados 
El tratamiento depende del tipo de daño a los nervios que tenga, y puede incluir: • Control del dolor con medicamentos, fisioterapia u otros tratamientos. • Medicamentos para tratar la diarrea o estreñimiento. • Comer pequeñas cantidades de comidas después de algunas horas y limitar las grasas y fibras por problemas de indigestión. • Fisioterapia para aliviar los problemas de coordinación. • Si tiene problemas en los pies, hable con su médico acerca de una derivación a un podólogo. Los nervios que van a los pies suelen verse afectados por la neuropatía diabética. Ì La pérdida de sensibilidad puede hacer que no sienta una llaga o una ampolla. Ì Los problemas de circulación pueden contribuir al riesgo de infección y hacer más lenta la curación de los pies.

Control de la diabetes 
También debe controlar su diabetes según las instrucciones de su médico para mantener sus niveles de azúcar en la sangre dentro de los valores normales y prevenir daños adicionales en el futuro: • Mida su azúcar en la sangre con frecuencia. • Tome sus medicamentos para la diabetes como se lo indicaron. • Siga su plan de alimentación. • Haga ejercicio diariamente. • Cuide los pies a diario para protegerlos. Hable con su médico o enfermera si tiene alguna pregunta o duda.

Fuente: Diabetes and Nerve Damage. Spanish. healthinfotranslations.org@2012- January 12, 2017 Información de Salud

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