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Diabetic neuropathy: pathogenesis and therapy.

A I Vinik1

  • 1Strelitz Diabetes Institutes, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk 23510, USA.

The American Journal of Medicine
|September 14, 1999
PubMed
Summary
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Diabetic neuropathies are diverse nervous system disorders. Effective treatment requires addressing the root cause, not just symptoms, with various therapeutic options available.

Area of Science:

  • Neurology
  • Endocrinology
  • Diabetology

Background:

  • Diabetic neuropathies are complex disorders affecting peripheral and autonomic nervous systems.
  • These conditions lead to significant morbidity and mortality in diabetic patients.
  • Neuropathies present as focal or diffuse, proximal or distal, involving somatic and autonomic nerves.

Purpose of the Study:

  • To outline the classification and treatment strategies for various diabetic neuropathies.
  • To differentiate treatment approaches based on the specific type and etiology of neuropathy.
  • To review current and potential therapeutic interventions for diabetic neuropathy.

Main Methods:

  • Classification of neuropathies into focal (entrapment, mononeuropathies) and proximal/distal types.

Related Experiment Videos

  • Review of treatment modalities including symptomatic, etiological, metabolic, autoimmune, and pharmacologic approaches.
  • Discussion of non-pharmacologic therapies and medications for painful diabetic neuropathy.

    • Main Results:

    • Entrapment syndromes are treated by relieving compression; mononeuropathies resolve spontaneously with supportive care.
    • Proximal neuropathies, often autoimmune, require specific therapies guided by biopsy.
    • Distal polyneuropathies may benefit from metabolic treatments, autoimmune therapies, or nerve growth factors.
    • Painful diabetic neuropathy lacks a definitive treatment, with various medications and non-pharmacologic options explored.

    Conclusions:

    • Treatment of diabetic neuropathies must be etiology-based, with symptomatic management as an adjunct.
    • Diverse therapeutic strategies exist, ranging from surgical decompression to metabolic and autoimmune interventions.
    • Further research is needed for definitive treatments, especially for painful diabetic neuropathy.