The natural course of diabetic neuropathy. A follow-up

Out of an unselected group of 160 patients with diabetic neuropathy 51 patients were followed up for an average of 5, 6 years by repeated neurological examinations and by means of a questionnaire. The control of the diabetes was requested from the house physicians. The patients were classified as presenting (1) a symmetrical, predominantly sensory neuropathy (2) a mixed syndrome with additional autonomic neuropathy and (3) multiple mononeuropathy. Individual symptoms and objective signs of neuropathy revealed a remarkable variety of changes. The outlook in multiple mononeuropathy and distal paresis was favorable while autonomic failures, in particular of male sexual function, progressed. There seemed to be some beneficial effect of improved glycemic control. However, despite satisfactory metabolic control some progression of diabetic neuropathy occured.