CLINICAL ASPECTS OF DIABETIC NEUROPATHY
Abstract:
Approximately 30–50% of all diabetic patients are affected by neuropathy and it is the
commonest form of neuropathy in the developed world. Diabetic neuropathies are among most common
long-term complications of diabetes. Diabetic neuropathy (DN) is defined as the presence of symptoms
and/or signs of peripheral nerve dysfunction in people with diabetes mellitus after the exclusion of other
causes. There is now little doubt that glycaemic control and duration of diabetes are major determinants
of distal symmetrical neuropathy. Distal symmetric polyneuropathy, the most common form of diabetic
neuropathy, usually involves small and large nerve fibers. Small-nerve fiber neuropathy often presents
with pain and loss of intraepidermal nerve fibers, but without objective signs or electrophysiologic
evidence of nerve damage. The greatest risk from small-fiber neuropathy is foot ulceration and
subsequent gangrene and amputation. Large-nerve fiber neuropathy affects profund sensitivity. Some
patients may be completely asymptomatic, and signs may be only discovered by a detailed neurologic
examination.
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