Diabetic neuropathies: diagnosis and management

Area of Science:

• Endocrinology
• Neurology
• Diabetology

Background:

• Diabetes mellitus incidence has risen globally due to lifestyle changes.
• Diabetic neuropathy, a common complication, affects 8% of newly diagnosed and over 50% of long-standing cases.
• Two main types, sensorimotor and autonomic neuropathies, present distinct and severe clinical manifestations.

Purpose of the Study:

• To review the pathogenesis, clinical manifestations, diagnosis, and treatment of diabetic neuropathies.
• To highlight the prevalence and impact of sensorimotor and autonomic diabetic neuropathies.

Main Methods:

• Literature review on diabetic neuropathy.
• Analysis of pathogenesis, clinical features, diagnosis, and therapeutic strategies.

Main Results:

• Sensorimotor neuropathy involves pain, paresthesia, and sensory loss.
• Autonomic neuropathy can lead to cardiovascular, gastrointestinal (gastroparesis), and genitourinary complications.
• Strict glycemic control is the primary preventive measure, with limited additional therapeutic options.

Conclusions:

• Diabetic sensorimotor and autonomic neuropathies are prevalent and challenging to manage.
• Cardiovascular risk reduction and lifestyle interventions are recommended for autonomic neuropathy.
• Symptomatic treatment for sensory symptoms includes antidepressants and anticonvulsants; other strategies show limited efficacy.