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Treating Patients with Hypoglycemia and Autonomic Neuropathy

If you’re treating patients with diabetes, chances are very good that you’ve also got patients with hypoglycemia.

Many patients with diabetes are so accustomed to their symptoms that they don’t pay attention to the subtle changes that can present with hypoglycemia.  Often, they won’t have the very dramatic symptoms like loss of consciousness or diabetic coma.

More often, they have milder symptoms like[1]

∙           Tremor

∙           Sweating

∙           Heart palpitations

None of these are that severe and they might just write them off as a response to something going on in their everyday lives.  No big deal…nothing to worry about.

But they do have a problem and a potentially serious one.

That problem is hypoglycemia.

Hypoglycemia can occur in anyone with diabetes if they’re taking medication to lower their blood glucose.  If you have type 1 diabetes and you’re insulin dependent, you stand a good chance of developing hypoglycemia.

So how do you get these patients to come to you when they first notice these symptoms so you can help them with a proactive approach to their illness?

Educate your diabetes patients on the signs and symptoms of hypoglycemia and make sure they understand that the symptoms may appear to be mild but they can be physically devastating.

Understanding Why They May Not Recognize Symptoms

If your patient has type 1 diabetes, when their blood glucose levels fall, their insulin levels don’t decrease and their glucagon levels don’t increase.  They just reflect the body’s absorption of insulin.  It gives the body a false sense that all is right when all is wrong.   Because their body doesn’t register a problem, it loses its first two lines of defense against the imbalance in your system.  Their body’s normal response is impaired.

What Causes the Impairment?

Several things –

∙           The brain may have become used to hypoglycemia because it’s been dealing with it for awhile. If they’ve had frequent episodes, the system in the body responsible for transporting adrenaline to where it’s needed no longer senses a great need.  It just doesn’t respond.

∙           They may be using medications that mask their hypoglycemia symptoms and not even know it.  For example, if they take medications that are beta blockers, they’re designed to lessen the effects of adrenalin on the body.  They may not experience the tremors or heart palpitations that a normal person would during a hypoglycemic episode.  Beta blockers also block the liver from producing glucose so they’re giving the body a double whammy to deal with. Always ask your diabetic patients if they’re taking beta blockers as part of your history and physical.

∙           They may have autonomic neuropathy.  Explain to them that it’s a type of peripheral neuropathy that affects the nerves that control involuntary body functions like heart rate, blood pressure, digestion and perspiration.  The nerves are damaged and don’t function properly leading to a breakdown of the signals between the brain and the parts of the body affected by the autonomic nervous system like the heart, blood vessels, digestive system and sweat glands.  And, in their case, it may be inhibiting their liver from producing insulin.

Diagnosing and Treating Autonomic Neuropathy

Once you take a very thorough history and physical (preferably one following the NeuropathyDR® protocol for hypoglycemic and diabetic patients), you’ll have a better handle on your patient’s condition.  Pay particular attention to their symptoms, when they began, the severity of the discomfort, and any and all medications they currently take (including over the counter medications, herbal supplements or vitamins).

Watch for signs that they are not being completely up front about their diet, alcohol intake, frequency of exercise, history of drug use and smoking.  If they don’t tell the truth, you don’t have a clear picture of your physical condition.

Treatment and Prognosis

If you use the NeuropathyDR® protocol, you will find the treatment regimen ideally suited to treating diabetes, hypoglycemia and autonomic neuropathy.

Diabetes, hypoglycemia and autonomic neuropathy are chronic conditions but they can be treated and your patient can do things to help relieve their symptoms.

You can help them by offering[2]:

∙           Diet Planning and Nutritional Support

The body needs the proper the nutrition to heal.

If they have gastrointestinal issues caused by autonomic neuropathy, they need to make  sure they’re getting enough fiber and fluids to help the body function properly.  Provide them with a diet plan that ensures they get enough fiber, whole grains and drink enough      water.

If they have diabetes, work with them on a diet to control their blood sugar.

Devise a meal schedule as part of their dietary planning to keep their blood sugar levels as steady as possible.

∙          Individually Designed Exercise Programs

If your patient experiences exercise intolerance or blood pressure problems resulting  from autonomic neuropathy, develop an exercise regimen for them that will allow them to take things slowly but still work some physical activity into their daily routine.  Treating neuropathy patients requires specialized training in the design and monitoring of  exercise programs.  The NeuropathyDR® clinicians are specially trained in designing  exercise programs to meet the needs of the neuropathy patient.

Early intervention with a physician well versed in treating diabetes, hypoglycemia and autonomic neuropathy, like a NeuropathyDR® clinician, is still the best course of action. While you can’t reverse your patient’s condition if they have already developed neuropathy, you can help them achieve a better quality of life and lessen the chance of severe and possibly fatal complications.

When you’re trained and ready to work with them, let them know you’re there.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice web.com to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at http://perfectpracticeweb.com.

 

 

 

 


[1] http://diabetes.niddk.nih.gov/dm/pubs/neuropathies

[2] http://diabetes.webmd.com/complementary-and-alternative-diabetes-treatments

Hope for Your Patients With Infectious Diseases

 

What can you do for your patients with infectious diseases?

They’re miserable and their misery is understandable.

Look at what they’re dealing with[1]:

•     Extreme fatigue

•     Headaches

•     Painful, swollen joints

•     Anemia

•     Fever and chills

•     Swelling in your feet, legs or hands

•     Pleurisy

•     Rashes

•     Hair loss

If they have lupus, Lyme Disease[2], Varicella Zoster (aka Shingles), HIV/AIDS, Legionnaire’s Disease or any other infectious disease caused by a virus or bacteria, these symptoms can be just the beginning of their problems.

If they’ve delayed treatment, the next problem they could be faced with is

peripheral neuropathy and everything that comes with it.  Other than getting busy treating them to avoid peripheral neuropathy and nerve damage, one of the first things you need to do is educate your patient.

Explaining How Their Illness Can Cause Peripheral Neuropathy

Many infectious diseases are caused by viruses or bacteria.  Viruses and bacteria can attack nerve tissue and severely damage sensory nerves. If those nerves are damaged, your patient is going to feel the pain, quickly.

The virus that causes HIV, in particular, can cause extensive damage to the peripheral nerves.  Often, the progression of the disease can actually be tracked according to the specific type of neuropathy the patient develops.  Painful polyneuropathy affecting the feet and hands can be one of first clinical signs of HIV infection.

Any of these viral or bacterial disorders can cause indirect nerve damage and bring on conditions that we refer to as autoimmune disorders.  Autoimmune disorders cause the body’s immune system to go on the offensive and attack its own tissues.  These assaults by the body on the body damage the nerve’s protective covering.  Think of it as “internal friendly fire” – misdirected but potentially serious.

Many patients understand the more common symptoms of their illness but they don’t understand why they would have nerve damage.  Once they understand exactly why they’re having

•     Muscle weakness

•     Muscle cramps

•     Inability to feel sensation

•     Numbness or tingling

•     Burning

•     Loss of reflexes

•     Blood pressure problems

•     Sweating too much or too little

•     Heart rate issues and inability to feel chest pain

•     Bladder control issues

•     Diarrhea or constipation

•     Difficulty swallowing because your esophagus doesn’t function properly

•     Bloating

•     Heart burn

•     Inability to feel sensation in your hands and feet

They will better understand why you’re recommending the treatment your recommending.  Hearing that they have a virus or bacterial infection can be very misleading – they think all they need is medication and they’ll be fine.  Understanding exactly how these illnesses can cause peripheral neuropathy and nerve damage will make for a much more compliant patient.

The Best Course of Treatment

If your patient presents with any of these diseases, start treatment immediately.  The earlier you start treatment, the less likely they will be to develop peripheral neuropathy and nerve damage.  Your NeuropathyDR® protocol offers one of the best chances these patients have for minimizing or even avoiding nerve damage from peripheral neuropathy.

In addition to the NeuropathyDR® protocol and specific drug therapies designed for the particular condition, you also need to work with your patient on lifestyle issues.  Specifically,

•     Getting plenty of rest

•     Pacing themselves and limiting their activities

•     Exercising  regularly – walking, swimming and yoga are great exercises for neuropathy patients

•     Take care of their skin and limiting exposure to the sun

•     Quitting smoking

•     Eating a healthy, well balanced diet

•     Keeping high blood pressure under control

A Few Words To The Wise

Each of these conditions is very different and caused by different organisms.  For that reason, patients with different infectious diseases must be treated differently.  They’re nerve damage has resulted from different causes.

There are a few things to consider when treating these patients:

•     For female patients, it’s particularly important to be cautious about birth control.  Any of these infectious diseases can cause serious problems during pregnancy.

•     Make sure they receive vaccinations for flu and pneumonia to help prevent additional or secondary infections that could compromise their progress.

•     If they’ve been treated with corticosteroids for inflammation, make sure they are closely monitored for osteoporosis.

•     If your patient has lupus, make sure they receive regular eye exams.  Lupus can have an adverse effect on vision.

•     Lyme disease is on the rise so educate your patient population on the warning signs of infection – a tick bite followed by a bulls-eye shaped rash close to the bite site.

As a NeuropathyDR® clinician you can offer these patients the best chance possible for avoiding permanent nerve damage from their infectious disease.

Once you’re trained in the NeuropathyDR® treatment protocol and ready serve this challenging patient population, let us help you reach them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice web.com to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at http://perfectpracticeweb.com.