Si parla di neuropatia diabetica dolorosa (PDN) quando in una persona con diabete si combina una neuropatia periferica (NP) caratterizzata da danni diffusi alle fibre nervose periferiche e sintomi molto dolorosi.
Si stima che almeno 1 persona con neuropatia diabetica su 3 sviluppi una forma dolorosa.
Il diabete, sia di tipo 1 che di tipo 2, se mal gestito, può compromettere i nervi periferici (neuropatia periferica) in due modi:
I pazienti con una neuropatia dolorosa avvertono, oltre ai sintomi tipici della neuropatia periferica (formicolio, prurito, intorpidimento, sensazione di caldo o freddo eccessivo), un dolore acuto simmetrico che si manifesta con fitte pulsanti e punzecchiature come punture di spillo.
Il dolore si presenta soprattutto a riposo e di notte e viene scatenato in maniera eccessiva da uno stimolo doloroso (iperalgesia) o da stimoli che in condizioni normali non dovrebbero provocare dolore (allodinia).
I sintomi neuropatici dolorosi, spesso molto intensi, sono debilitanti e fanno la loro comparsa soprattutto di notte.
Il dolore neuropatico compromette in maniera rilevante la qualità della vita, in quanto interferisce con le attività quotidiane e con il sonno.
È documentato, inoltre, che la presenza di dolore cronico aumenta il rischio di difficoltà nell’autogestione del diabete, relativamente all’assunzione della terapia, attività fisica, adesione alla dieta, cura dei piedi e persino automonitoraggio glicemico.
La valutazione oggettiva di questa problematica può risultare difficile, al punto che più del 39% dei casi non riceve trattamento adeguato e tempestivo.
Non ignorare i primi segnali di complicanze nella speranza che scompaiano, il trattamento tempestivo è fondamentale per evitare che eventuali problematiche si aggravino.
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