Diabetic Polyneuropathy was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.
To view this entire topic, please sign in or purchase a subscription.
Explore 5-Minute Clinical Consult - view these FREE monographs:
-- The first section of this topic is shown below --
Basics
Description
Peripheral nerve dysfunction seen in diabetes; several patterns described:
- Symmetric polyneuropathy:
- Distal sensory or sensorimotor
- Proximal lower extremity polyneuropathy
- Focal and multifocal neuropathy:
- Cranial neuropathy
- Focal limb neuropathy
- Diabetic amyotrophy
- Truncal neuropathy
- Autonomic neuropathies
- Chronic inflammatory demyelinating polyneuropathy (CIDP)
Epidemiology
Prevalence
- Prevalence increases with diabetes duration
- Generalized polyneuropathy:
- 10% at diabetes diagnosis
- 50% at 25 years
- Cross-sectional prevalence: 15% by symptoms; 50% by nerve conduction
- Autonomic neuropathy: 16.7% in a UK study
Risk Factors
- Poor glycemic control
- Duration of diabetes
- Hypertension
- Hyperlipidemia
- Vitamin D deficiency
General Prevention
Maintenance of normal blood sugar
Pathophysiology
- >1 pathogenetic factor may operate
- Metabolic derangement due to hyperglycemia:
- Aldose reductase converts excess glucose to sorbitol, which causes nerve damage.
- Nonenzymatic glycation of neural proteins and lipids forms damaging advanced glycosylation end products.
- Protein kinase C activation causes vascular endothelial changes.
- Oxidative stress from excessive production of reactive oxygen species
- Vasculopathy causing nerve ischemia: Predominant factor in mononeuropathies
Etiology
Diabetes mellitus (type 1 and 2)
-- To view the remaining sections of this topic, please sign in or purchase a subscription --
