Diabetic Neuropathy

Diabetic Neuropathy e/kqesgtfur Luk;qfodkj Mk vkyksd dqekj xqIrk( ,e0Mh(ihthlhlh¼Mk;fcVht½

vf/kdk’ka e/kqesg jksfx;ks esa gksus okyk ihMknk;d fodkj • 10 & 90 iz ‘k e/kqesgh izHkkfor • ik¡o es ?kko dk izeq[k dkj.k • ik¡o es lajpukRed fodkj dk izeq[k dkj.k • vax foPNsnu dk izeq[k dkj.k • thou xq.koŸkk dks izHkkfor djus okyk fodkj

tksf[kedkjd (Risk Factor) • e/kqesg dh vof/k • e/kqesg dh rhozrk • iq#’k fyax • /kqeziku • jSfVuksiSFkh] • ew= esa izksVhu fjlko • efnjk lsou

rafrzdk rarz& oxhZdj.k Central- dsfUnz; Peripheral- ifjf/ktU; Voluntary- ,sfPNd Involuntary- vuSfPNd Autonomic

,sfPNd raf=dk ra= ds fodkj Sensory nervous system fofHkUu izdkj ds laosnukvksa ¼Nwuk] rki] nnZ½ dks efLr’d rd igqpkuk Motor nervous system ekalisf”k;ksa }kjk ,sfPNd dk;Z dks lapkfyr djus gsrq efLr’d }kjk tkjh funsZ”k dks lEcaf/kr ekalisf”k;ksa rd igqpkuk

Sensory nervous system gkFk iSjks esa >qu>qukgV] lwukiu] tyu ] lwbZ pqHkus tSlk ,glkl] :bZ ij pyus tSlk ,glkl, lksrs le; iSjks+ es rhoz ihMktSls fodkj gksus yxrs gSa

Motor nervous system Motor Luk;q ra= ds {kfr igqapus ds dkj.k] ekalisf”k;ksa esa detksjh vkus ds dkj.k] fo”ks’k dj iSj ds iatksa dh NksVh ekalisf”k;ksa dh “kfDr {kh.k gksus ds dkj.k iatksa dh ukSlZfxd cukoV esa fodkj vk tkrk gS ftlds dkj.k iatksa esa “kjhj ds Hkkj dks lgh <ax ls ogu djus esa fnDdr gksrh gS vkSj vlekU; ncko fcUnq cu tkrs gSaA tgka vf/kd ncko iM+us ds dkj.k ?kko gksus dh lEHkkouk c<+ tkrh gSA

Motor nervous system • e/kqesg jksfx;ksa esa dHkh&dHkh efLr’d ds Luk;q ds {kfr igqapus ds dkj.k vk/ks psgjs ij Qkfyt ¼iSjkfyfll½ vk[kksa ds iSjkfyfll dh Hkh f”kdk;r gks ldrh gSA cranial nerves }kjk igqapus okyh {kfr 4 ls 6 lIrkg esa iwjh rjg ls Bhd gks tkrk gS A • dqN jksfx;ksa esa dwYgs ,oa tka?k dh ekalisf”k;ksa esa detksjh vk tkrh gS] ftlds dkj.k jksxh dks tehu ij cSBus ,oa mBus esa dfBukbZ gksus yxrh gSA

vuSfPNd ra= fodkj • ysVs ;k cSBh voLFkk ls [kM+s gksus ij jDrpki esa deh (Postural hypotension) ds dkj.k pDdj@vk[kksa ds lkeus {kf.kd va/ksjk Nk tkukA • foJke dh voLFkk esa Hkh mPp ân; xfrA • foJke ,oa Je dh voLFkk esa gksus okys ân; xfr ifjorZu dk u gksuk • Hkkstu dk yEcs le; rd vkek”k; esa jgus ds dkj.k isV esa Hkkjhiu] vip] fepyh ,oa dHkh&dHkh mYVhA • jkf= ds le; dbZ ckj “kkSp dk gksukA • dbZ&dbZ fnu “kkSp dk u gksukA • ySafxd f”kfFkyrkA • ew= foltZu esa fnDdr ,oa ew= FkSyh esa ew= dk teko ,oa Qy Lo#i ew= laØe.kA • vR;f/kd ilhukA • ilhus dk u gksuk & Ropk dk #[kkiu ,oa Ropk dk QVukA • ikWo esa lwtuA

funku • #bZ ds Qkgs }kjk iatksa dks Nw, vkSj ns[ksa dh bldk laKku vki dj ikrs gSa fd ughaA • nks “khf”k;k¡ ysa vkSj bl esa BaMk ty ,oa nwljs esa gydk xeZ ty Hkj ysaA bls fdlh ls vki vius iatksa ij yxkus ds fy, dgsa vkSj ns[ksa fd vki BaMk xeZ dk lgh vkdyu dj ikrs gSa ;k ughaA • eksuksfQykesUV VsLV

Sensory Neuropathy Leads to Loss of Protective Sensation • Nylon Monofilament (5.07 thickness) equivalent to 10 gm of linear force • Light touch by cotton wool

D;k djsa • mfpr e/kqesg fu;eu • rEckdw ,oa efnjk dk lsou u djsaA • uaxs ikWo dHkh u py • uk[kwu dks xgjk u dkVsa • xeZ ty ls ikWo dh fldkbZ u djsa • vk¡p u rkisa • mfpr eki ds twrs igus ,oa iguus ls igys ns[k ysa fd twrs ds vUnj dksbZ oLrq u gks

e/kqesg dks le>sa fu;rz.k viusa gkFkksa esa ysa /kU;okn

Diabetic Neuropathy