[Diabetic neuropathy]

Neuropathy is a frequent late complication of diabetes. The severity and duration of hyperglycaemia are probably the principal causal factor. The consequences of the effects of neuropathy on the lower-limb and the autonomic nervous system are major causes of morbidity. Apart from glycaemic control, no specific treatment is yet available, but measures for symptomatic alleviation of certain painful and visceral manifestations of diabetic neuropathy exist and are outlined in these guidelines. The guidelines also describe simple diagnostic strategies for detecting potentially threatening neurological signs, notably reduction or loss of lower-limb sensation which expose the patient to the risk of ulceration, unnoticed trauma and amputation. The guidelines also summarize the preventive educational measures required to minimize these risks.