Diabetic neuropathy part 1: overview and symmetric phenotypes

Abstract

Diabetes is the most common cause of neuropathy in United States and neuropathies are the most common complication of diabetes mellitus, affecting up to 50% of patients with type 1 and type 2 diabetes mellitus. Symptoms usually include numbness, tingling, pain, and weakness. Dizziness with postural changes can be seen with autonomic neuropathy. Metabolic, vascular, and immune theories have been proposed for the pathogenesis of diabetic neuropathy. Axonal damage and segmental demyelination can be seen with diabetic neuropathies. Management of diabetic neuropathy should begin at the initial diagnosis of diabetes and mainly requires tight and stable glycemic control.

Copyright © 2013 Elsevier Inc. All rights reserved.

Figures

Figure 1

Spectrum of possible pathophysiologic causes of various diabetic neuropathies

Figure 2

Patient’s weight over time and the onset of neuropathic pain and initiation of diabetic therapy. +=Initiation of oral hypoglycemic; *=initiation of insulin; ↓=onset of pain