[Diabetic asymmetric proximal neuropathy].

Area of Science:

• Neurology
• Endocrinology
• Diabetology

Background:

• Diabetic neuropathy is a common complication of diabetes mellitus.
• Diabetic asymmetric proximal neuropathy (DAPN) is a less common but significant form.
• Understanding DAPN's prevalence and characteristics is crucial for patient management.

Purpose of the Study:

• To determine the prevalence of DAPN in patients with diabetes mellitus (DM).
• To describe the clinical features and risk factors associated with DAPN.
• To evaluate treatment strategies for DAPN and associated neuropathic pain.

Main Methods:

• Cross-sectional study of 445 patients with DM (Type I and Type II).
• Clinical examination and assessment of neuropathy types (distal symmetric polyneuropathy, autonomic neuropathy, mononeuropathy, DAPN).
• Analysis of patient demographics, glycemic control, and disease duration.

Main Results:

• DAPN prevalence was 7.9%, higher in DM Type II (9.6%) with poor glycemic control and longer duration (>5 years).
• Key DAPN symptoms include radicular pain, paresthesia, and amyotrophy beyond myotomes.
• Distal symmetric polyneuropathy (62%) and autonomic neuropathy (25.6%) were also prevalent.

Conclusions:

• DAPN is a distinct neuropathy in diabetes, linked to poor glycemic control and DM duration.
• Combination therapy (pregabalin, duloxetine, vitamin B complex) shows efficacy for neuropathic pain.
• Further investigation into glucocorticoids and immunoglobulin therapy for DAPN is warranted.