Diabetic NeuropathyDiabetic Neuropathy

Dr. Herjanti rahajeng SpPDDr. Herjanti rahajeng SpPD

Apa itu Neuropati diabetik?Apa itu Neuropati diabetik?

Neuropati diabetik adalah gangguan Neuropati diabetik adalah gangguan syaraf pada pasien diabetes mellitussyaraf pada pasien diabetes mellitus

Gangguan syaraf terutama pada syaraf Gangguan syaraf terutama pada syaraf tepi.tepi.

StatsStats

60-70% pasien DM menderita neuropati60-70% pasien DM menderita neuropati

11-32% pasien dengan neuropati 11-32% pasien dengan neuropati mengalami keluhan nyerimengalami keluhan nyeri

More SpecificallyMore Specifically

TipeTipe– Diffuse Peripheral Diffuse Peripheral

NeuropathyNeuropathy– Diffuse Autonomic Diffuse Autonomic

NeuropathyNeuropathy– Localized Peripheral Localized Peripheral

NeuropathyNeuropathy

PenyebabPenyebab

Tidak diketahuiTidak diketahuiTeori NeuropatiTeori Neuropati– High Glucose High Glucose

ConcentrationConcentrationChemical changes in Chemical changes in nervesnervesDamaged blood Damaged blood vesselsvessels

– Genetic DispositionGenetic Disposition

GejalaGejalaTergantung daerah yang Tergantung daerah yang terkenaterkenaDiffuse PeripheralDiffuse Peripheral– NyeriNyeri– Tidak merasakan atau Tidak merasakan atau

kesemutankesemutan– Kepekaan berlebihKepekaan berlebih– Loss of Balance and Loss of Balance and

ControlControlDiffuse AutonomicDiffuse Autonomic– Infeksi sal kencingInfeksi sal kencing– Gangguan pencernaanGangguan pencernaan– dizzinessdizziness

GejalaGejala

Localized neuropathyLocalized neuropathy– Pain in front of thigh, Pain in front of thigh,

lower back, chest lower back, chest stomach and behind stomach and behind eyeseyes

– Double visionDouble vision– Paralysis of one side Paralysis of one side

of the faceof the face

Cara mendiagnosaCara mendiagnosaTergantung gejala Tergantung gejala yang timbulyang timbul– Pain AssessmentPain Assessment– Screening Test for lost Screening Test for lost

sensationsensation– Nerve Conduction Nerve Conduction

StudyStudy– ElectromyographyElectromyography– UltrasoundUltrasound– Nerve Biopsy (extreme Nerve Biopsy (extreme

cases)cases)

Faktor ResikoFaktor Resiko

Diabetes terutama dengan HyperglycemiaDiabetes terutama dengan HyperglycemiaLama terkena DiabetesLama terkena DiabetesMerokokMerokokAlkoholAlkoholBerat badan lebihBerat badan lebih

TerapiTerapi

Menjaga kadar gula darahMenjaga kadar gula darahObatObatTerapi nyeriTerapi nyeriTerapi dini meningkatkan keberhasilanTerapi dini meningkatkan keberhasilan

How to Maintain a Healthy LifestyleHow to Maintain a Healthy Lifestyle

Manage DiabetesManage Diabetes

Don’t Drink AlcoholDon’t Drink Alcohol

Avoid CigarettesAvoid Cigarettes

Check your feet Check your feet regularlyregularly

Sources of InformationSources of Information

Duby, J.J., Campbell, R.K., Setter, S.M., White, J.R., & Duby, J.J., Campbell, R.K., Setter, S.M., White, J.R., & Rasmussen, K.A. (2004). Diabetic neuropathy: An Rasmussen, K.A. (2004). Diabetic neuropathy: An intensive review. intensive review. American Journal of Health-System American Journal of Health-System PharmacistsPharmacists. . 6161, 160-173. , 160-173.

Huizinga,M.M., & Peltier, A. (2007). Painful Diabetic Huizinga,M.M., & Peltier, A. (2007). Painful Diabetic Neuropathy: A Management-Centered Neuropathy: A Management-Centered Review. Review. Clinical Clinical DiabetesDiabetes. . 2121, 6-15., 6-15.

Longe, J.L. (Ed.). (2002). Longe, J.L. (Ed.). (2002). The gale encyclopedia of The gale encyclopedia of medicinemedicine. Farmington Hills, MI: Gale Group. . Farmington Hills, MI: Gale Group.

Wong, M., Chung, J.W.Y., & Wong, T.K.S. (2007). Effects Wong, M., Chung, J.W.Y., & Wong, T.K.S. (2007). Effects of treatments for symptoms of painful diabetic of treatments for symptoms of painful diabetic neuropathy: systematic review. neuropathy: systematic review. BMJBMJ. . 8787, 335-45. , 335-45.

Sources of PictureSources of Picturehttp://www.european-hospital.com/topics/http://www.european-hospital.com/topics/article/2523.html article/2523.html www.rdehospital.nhs.uk/.../neuropathy.jpgwww.rdehospital.nhs.uk/.../neuropathy.jpghttp://www.mamc.amedd.army.mil/referral/http://www.mamc.amedd.army.mil/referral/images/neuropathic_ulcer_3x4.jpgimages/neuropathic_ulcer_3x4.jpghttp://www.covhealth.com/docs/ultrasoundhttp://www.covhealth.com/docs/ultrasound%20machine.jpg%20machine.jpghttp://www.bjmc.net/images/neuropathy.gifhttp://www.bjmc.net/images/neuropathy.gifhttp://www.recipeland.com/ara/media/item/http://www.recipeland.com/ara/media/item/2540.jpg2540.jpg