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Classification of diabetic neuropathy from pathogenetic aspects
Endokrinologie
|July 1, 1982
Summary
Diabetic nervous disturbances, including polyneuropathy (PNP), can be classified into four groups. Early diabetic neuropathy may be reversible with metabolic control, while type I diabetic PNP correlates with disease duration and microangiopathy.
Area of Science:
- Neurology
- Endocrinology
- Diabetology
Background:
- Diabetic nervous disturbances are common complications of diabetes mellitus.
- Electroneurography and respiratory heart arrhythmia measurement are key diagnostic tools.
- Understanding the classification and progression of diabetic neuropathy is crucial for patient management.
Purpose of the Study:
- To report on electroneurographic examinations of 800 diabetic patients.
- To present results from respiratory heart arrhythmia measurements in 215 diabetic patients.
- To propose a classification system for diabetic nervous disturbances.
Main Methods:
- Electroneurographic examinations were performed on 800 diabetic patients.
- Respiratory heart arrhythmia measurements were conducted on 215 diabetic patients.
- Diabetic nervous disturbances were categorized into four distinct groups.
Main Results:
- A proposed classification includes early/subclinical disturbances, type I polyneuropathy (PNP), type II polyneuropathy, and mononeuropathy.
- Early diabetic nervous disturbances (Group 1) showed reversibility with metabolic control.
- Polyneuropathy in type I diabetics (Group 2) demonstrated a significant correlation with diabetes duration and microangiopathy, suggesting a 'dying back' neuropathy potentially linked to a catabolic state.
Conclusions:
- A novel classification system for diabetic nervous disturbances is proposed.
- Metabolic control is vital for managing early-stage diabetic neuropathy.
- Type I diabetic polyneuropathy is associated with disease progression and microvascular complications, indicating a distinct pathophysiological mechanism.