Evaluation in Diagnosis and Management of Diabetic Neuropathy
- 1 Broadlawns Medical Center, Des Moines, USA
- 2 University of Iowa Hospitals & Clinics, Iowa City, USA
- 3 University of Iowa, Iowa City, USA
Abstract
The 100-year anniversary of insulin is explored by focusing on diabetic neuropathy. Neuropathy is so common to diabetes, it is well described even in the earliest accounts of diabetes. This article reviews the most common neuropathy syndromes, and the consensus of effective treatment for neuropathic pain. Pharmacological advances in neuropathy are still largely focused on pain control, not neuropathy intervention. The article reviews the established and lesser tested therapies used for pain control. It also reviews the pathophysiology of the disease state, including the many factors and steps that culminate to produce neuropathy and its different iterations. In the future, new ways to treat diabetic neuropathy may be geared toward treating specific pathophysiological step-points on the way to nerve damage. In the future, prevention and a deeper look at the impact of socioeconomic status as a predictor of diabetes will hopefully encompass a bigger part of pre-diabetic care.
- Skljarevski, V. and Lledo, A. (2006) Diabetic Neuropathies. Archives of Neurology, 63, 1502-1504. https://doi.org/10.1001/archneur.63.10.1502
- Hurst, G.C. (1979) Michinaga’s Maladies. A Medical Report on Fujiwara No Michinaga. Monumenta Nipponica, 34, 101-112. https://doi.org/10.2307/2384283
- Skljarevski, V. (2007) Historical Aspects of Diabetic Neuropathies. Humana Press, Totowa, 1-5. https://doi.org/10.1007/978-1-59745-311-0_1
- Garland, H. (1960) The Neurological Complications of Diabetes Neurological Complications of Diabetes Mellitus: Clinical Aspects. Proceedings of the Royal Society of Medicine, 53, 137-141. https://doi.org/10.1177/003591576005300210
- Tesfaye, S., Boulton, A.J.M., Dyck, P.J., Freeman, R., Horowitz, M., Kempler, P., Lauria, G., Malik, R.A., Spallone, V., Vinik, A., et al. (2010) Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments. Diabetes Care, 33, 2285-2293. https://doi.org/10.2337/dc10-1303
- Schott, B. (1962) Neurological Complications of Diabetes. https://pubmed.ncbi.nlm.nih.gov/13909194/
- London, Z.N. (2020) A Structured Approach to the Diagnosis of Peripheral Nervous System Disorders. Peripheral Nerve and Motor Neuron Disorders, 26, 1130-1160. https://doi.org/10.1212/CON.0000000000000922
- Rundles, R.W. (1945) Diabetic Neuropathy General Review with Report of 125 Cases. Medicine, 24, 111-160. https://doi.org/10.1097/00005792-194505000-00001
- Callaghan, B.C., Little, A.A., Feldman, E.L. and Hughes, R.A. (2012) Enhanced Glucose Control for Preventing and Treating Diabetic Neuropathy. Cochrane Database of Systematic Reviews, Article No. CD007543 https://doi.org/10.1002/14651858.CD007543.pub2
- Gemignani, F. (2009) Acute Painful Diabetic Neuropathy Induced by Strict Glycemic Control (“Insulin Neuritis”): The Old Enigma Is Still Unsolved. Biomedicine & Pharmacotherapy, 63, 249-250. https://doi.org/10.1016/j.biopha.2009.01.002
- Oyibo, S.O., Prasad, Y.D.M., Jackson, N.J., Jude, E.B. and Boulton, A.J.M. (2002) The Relationship between Blood Glucose Excursions and Painful Diabetic Peripheral Neuropathy: A Pilot Study. Diabetic Medicine, 19, 870-873. https://doi.org/10.1046/j.1464-5491.2002.00801.x
- Dejgaard, A. (1998) Pathophysiology and Treatment of Diabetic Neuropathy. Diabetic Medicine, 15, 97-112. https://doi.org/10.1002/(SICI)1096-9136(199802)15:2 3.0.CO;2-5