An introduction to Diabetic Neuropathy: A Review

Author : Dr. Zaffar Hussain

Diabetic neuropathy is the most frequent and devastating complication of diabetes mellitus leading to great morbidity and mortality, resulting in a massive financial burden for diabetes care. The prevalence of diabetic neuropathy ranges from 10% within one year of diagnosis of diabetes mellitus to 50% of patients with diabetes for greater than 25 years. Symptoms associated with large fibre damage include weakness, numbness, burning or tingling, and loss of balance, while those related with small fibre damage include pain, anaesthesia to pin and temperature sensation, and autonomic dysfunction. Chronic persistent hyperglycaemia is the key component and should not be overlooked because the progression of the disease may lead to diabetic foot. The objective of the article is to provide a detailed summary of definition, pathogenesis, classification, diagnosis and management of the patients with diabetic neuropathies. Good clinical history and complete physical examination including foot inspection to support the need for regular self-care are the basis of assessment followed by therapeutic and laboratory studies. Strict control of blood sugar is the single utmost preventive measure for diabetic neuropathy. Timely diagnosis and management of dyslipidaemia and hypertension, may aid to prevent, delay, or slow the development of diabetic neuropathy. Management of painful diabetic neuropathy includes tricyclic compounds, serotonin–norepinephrine reuptake inhibitors (e.g. duloxetine), antiepileptics (e.g. pregabalin), opiates, and physical therapies, the antioxidant alpha lipoic acid and topical medications.

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