Endocrine » Diabetes

Diabetic Neuropathy

DIABETIC NEUROPATHY is defined as "the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes." The various theories postulated are Metabolic theory ,Vascular (ischaemic-hypoxic) theory ,Altered neurotrophic support theory, Laminin theory, Autoimmune theory. Classification includes Symmetric polyneuropathies and asymmetric polyneuropathies, Distal symmetric polyneuropathy, Small-fiber neuropathy, Large-fiber neuropathy, Diabetic autonomic neuropathy, Diabetic neuropathic cachexia, Asymmetric) Diabetic polyradiculopathy thoracoabdominal neuropathy, Lumbosacral radiculoplexopathy, Acute painful neuropathy (diabetic cachexia), Chronic inflammatory demyelinating polyneuropathy (CIDP) may also be seen in patients with diabetes. Approach includes a detailed history and clinical neurological examination. Prevention is by control of hyperglycaemia and after the advent the emphasis is on prevention and progression of complications like foot ulcers. Various modalities tried in neuropathy and the pain associated with it are alpha lipoic acid, evening primrose oil, capsaicin cream and antidepressants like Amitriptyline also gabapentin also have been useful.

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