Diabetic encephalopathy is a pathological condition caused by diffuse degenerative changes in the brain area. The main cause of the development of this disease is long-lasting diabetes. To date, this pathology is usually attributed to dyscirculatory disorders. In other words, changes in the brain result from a slowly progressive violation of the cerebral circulation. The prognosis for diabetic encephalopathy is always serious. In advanced cases, this disease can cause dementia, which leads to disability of a sick person. Other possible complications include ischemic stroke, intracranial hemorrhage, and so on.
In nineteen twenty-two, a number of authors indicated that some patients with diabetes mellitus develop cognitive disorders in varying degrees. This pathological condition got its present name only in nineteen fiftieth year. As we have said, from a traditional point of view, diabetic encephalopathy refers to dyscirculatory disorders. However, many scientists are inclined to believe that metabolic disorders also play a role in brain damage. To date, there is no accurate data on the prevalence of diabetic encephalopathy in the population. In this case, it is assumed that to some extent such a disease is present in more than half of diabetics.
We have already said that the main risk factor is a long-flowing sugar diabetes. As a rule, this complication is formed no earlier than ten years from its debut. Significantly increases the likelihood of developing this pathological process such a condition as diabetic dyslipidemia. In diabetic dyslipidemia, there is a violation of lipid metabolism, which leads to the deposition of cholesterol plaques in the lumen of the vessels, including cerebral. These changes lead to the fact that the blood stops flowing into the brain tissue in the required amount.
Significantly increases the rate of development of this disease with prolonged hyperglycemia, as well as with sharp drops in blood glucose levels. Concomitant arterial hypertension is detected in most diabetics. It also refers to predisposing factors and adversely affects the cerebral blood supply. Separately, it is worth mentioning about such an important moment as the age of the patient. The older a sick person, the more pronounced degenerative changes in his brain are present.
In addition, diabetes can be complicated by diabetic encephalopathy in the presence of overweight, non-compliance with the recommendations of the doctor regarding diet and drugs. It is worth noting that men and women equally often face such a violation.
Currently, diabetic encephalopathy is considered as a complex disorder caused by both vascular and metabolic disorders. As for vascular disorders in diabetes mellitus, they are mainly associated with the deposition of cholesterol plaques in the lumen of large, medium and small vessels.Against this background, the blood supply to the cerebral tissues is inhibited, which leads to an increasing oxygen starvation. In parallel, a series of complex biochemical reactions is launched , the outcome of which is the release of free radicals and their subsequent damage to the cerebral tissues. Cell structures undergo degenerative changes, due to which diffusely located pathological foci appear.
Symptoms of diabetic encephalopathy
Diabetic encephalopathy is accompanied by slowly progressive symptoms. In the early stages, a characteristic clinical picture may appear after an attack of acute hyperglycemia or with a sharp decrease in glucose level. In the future, specific complaints begin to be present constantly. At first, a sick person indicates the presence of a headache, rapid weakness and fatigue, as well as difficulties in trying to concentrate.
Further symptoms such as memory impairment and absent-mindedness follow. Often there are complaints of constantly depressed mood, difficulty falling asleep. The patient may indicate recurrent dizziness, palpitations. Sometimes there are sudden bouts of irritability and aggression.Another characteristic clinical manifestation is syncope.
Often, the clinical picture is complemented by focal disorders. They can be represented by discoordination of movements, an increase in muscle tone and a decrease in muscle strength, anisocoria, and so on.
In general, the symptoms of diabetic encephalopathy are not very specific. They can vary considerably in each individual patient.
Diagnosis and treatment of the disease
First of all, the diagnosis of diabetic encephalopathy is based on a thorough neurological examination. It is imperative to find out how long a person has been diagnosed with diabetes, as well as what kind of therapy he receives. From laboratory studies the most informative biochemical blood test. In addition, electroencephalography, magnetic resonance imaging, duplex vascular scanning, rheoencephalography, and so on are additionally performed.
Treatment for this disease begins with the normalization of glucose levels. Of the drugs used are nootropics, vasoactive and antioxidant agents, antiplatelet agents. According to the indications prescribed drugs aimed at lowering blood pressure, as well as statins. In addition, the treatment plan is supplemented with vitamin therapy, sedatives, and so on.
Preventing the development of encephalopathy in diabetes
Main methods prophylaxis are careful monitoring of glucose levels, adequate selection of glucose-lowering therapy, as well as timely correction of concomitant vascular disorders.