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Diabetic neuropathies

P A Low1, G A Suarez

  • 1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.

Bailliere'S Clinical Neurology
|November 1, 1995
PubMed
Summary
This summary is machine-generated.

Diabetic neuropathies encompass various forms, with distal sensory neuropathy being most common. Strict glycemic control is crucial for managing nerve damage and symptoms.

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Area of Science:

  • Neurology
  • Endocrinology
  • Diabetology

Background:

  • Diabetic neuropathy presents a spectrum of peripheral nerve disorders.
  • Distal sensory neuropathy is the most prevalent form.
  • Small-fiber neuropathy involves autonomic failure and sensory loss (pain, temperature).

Purpose of the Study:

  • To review the diverse clinical presentations of diabetic neuropathies.
  • To explore the multifactorial pathogenesis of diabetic neuropathy.
  • To discuss current and potential treatment strategies.

Main Methods:

  • Literature review of diabetic neuropathy.
  • Analysis of pathogenic mechanisms including hyperglycemia, microvascular dysfunction, and immune factors.
  • Evaluation of clinical trial data on treatment efficacy.

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Main Results:

  • Hyperglycemia centrally impacts nerve blood flow via microvascular effects (oxidative stress, altered nitric oxide, prostaglandins, endothelin).
  • Nerve fibers may also be directly affected by hyperglycemia.
  • Asymmetric neuropathies suggest microvascular and immune-mediated contributions.

Conclusions:

  • Strict glycemic control is paramount in managing diabetic neuropathy.
  • Treatment focuses on glycemic control and symptomatic relief.
  • Further research is needed to establish the role of other therapeutic modalities.