Image caption : Diabetes and Nerve Damage : Diabetic nerve damage, or neuropathy, can occur in nerves of every kind, throughout the body. Every organ system may be affected, including the digestive tract, heart, eyes, and sex organs, because nerves control or help to regulate all the organ systems. No fewer than 60-70% of people with diabetes have some form of neuropathy. It can result in serious complications.

Complications of Diabetes (from LtoR): Retinopathy, Nephropathy and Neuropathy.

1) Capillary within Muscle Tissue - The body's blood vessels, consisting of arteries, veins, and capillaries, range in size from arteries as wide as a garden hose to capillaries so thin that it would take 10 of them, lined up side by side, to form the thickness of a human hair. But they all have one thing in common: they are designed to move blood as quickly and efficiently as possible. That means they need to be strong, flexible, and smooth. Even the components of your blood, like red blood cells, platelets, and white blood cells, are designed for movement. Red blood cells can actually flex so that they are able to flow through the finest of capillaries. Damage to blood vessels is something that all the main complications of diabetes have in common. Diabetes injures both large vessels (arteries) and small vessels (capillaries), leading to atherosclerosis and many other disorders. When the level of glucose in the blood is high, insulin signals certain cells, including muscle, fat, and liver cells, to take glucose in. Without insulin, glucose can't get into the cells, so it remains in the bloodstream. When blood glucose levels are too high (hyperglycemia), many serious health conditions can result. Cardiovascular disease (diseases of the heart and blood vessels) frequently accompanies diabetes because high levels of glucose act as a toxin to the lining of the blood vessels. About three quarters of people with diabetes die of cardiovascular disease. 2) Insulin and Glucose in Arteriole - GLUT4 is an insulin-regulated glucose transporter expressed primarily in muscle and fat cells. When GLUT4 cannot function properly, you develop insulin-resistance, leading to a buildup of glucose (pink) and insulin (yellow) in the bloodstream. Capillaries, the smallest blood vessels in your body, are where nutrients are transferred from blood to cells, and waste from cells to the blood. Too much glucose in the blood, a condition called hyperglycemia, leads to a number of problems including microangiopathy marked by endothelial cell apoptosis (programmed cell death), accumulation of AGEs (advanced glycation end products), and thickening of the basement membrane, which can lead to development of lesions, vasoconstriction, and altered vessel function. 3) Insulin Dispersion - Insulin is a potent hormone that has a powerful effect on many of the cells in the body. Rising glucose levels in the blood signal the pancreatic beta cells to produce and release greater amounts of insulin into the bloodstream. Without insulin, glucose would not be able to penetrate through cells' plasma membranes and enter into cell interiors. Glucose is the body's main and most vital fuel. In fact, some cells of the body, such as brain cells and red blood cells, use only glucose as fuel. Insulin causes skeletal muscle fiber cells, liver cells, fat cells, and red blood cells to take up glucose from the blood and use it for energy or store it as glycogen to prepare for energy needs, or (in the case of fat cells) use it to make fat. Insulin attaches to special sites on the cell membrane called insulin receptors. This attachment starts a long chain of events that lead to an increase in the number of glucose transporters, specialized protein molecules in the cell membrane. The glucose transporters form channels in the cell's membrane that allow glucose to enter the cell through a process called facilitated diffusion. The net result of all these insulin-mediated actions is the lowering of the glucose (blood sugar) level. 4) Insulin Dispersion with Molecular Inset - Insulin is a potent hormone that has a powerful effect on many of the cells in the body. Rising glucose levels in the blood signal the pancreatic beta cells to produce and release greater amounts of insulin into the bloodstream. Without insulin, glucose would not be able to penetrate through cells' plasma membranes and enter into cell interiors. Glucose is the body's main and most vital fuel. In fact, some cells of the body, such as brain cells and red blood cells, use only glucose as fuel. Insulin causes skeletal muscle fiber cells, liver cells, fat cells, and red blood cells to take up glucose from the blood and use it for energy or store it as glycogen to prepare for energy needs, or (in the case of fat cells) use it to make fat. Insulin attaches to special sites on the cell membrane called insulin receptors. This attachment starts a long chain of events that lead to an increase in the number of glucose transporters, specialized protein molecules in the cell membrane. The glucose transporters form channels in the cell's membrane that allow glucose to enter the cell through a process called facilitated diffusion. The net result of all these insulin-mediated actions is the lowering of the glucose (blood sugar) level.

The photo shows the measuring of the nerve conduction velocity (the speed, in meters per second, at which an impulse moves along the largest fibers of a peripheral nerve.)

Manual Therapy Techniques

Diabetic nerve damage, or neuropathy, can occur in nerves of every kind, throughout the body. Every organ system may be affected, including the digestive tract, heart, eyes, and sex organs, because nerves control or help to regulate all the organ systems. No fewer than 60-70% of people with diabetes have some form of neuropathy. It can result in serious complications.