Diabetic Neuropathy—New Concepts of Its Etiology

TLDR: This review is concerned with the clinical, electrophysiologic, histologic, and biochemical concomitants of diabetic distal symmetric polyneuropathy that appear to shed some light on the underlying pathogenetic mechanisms.

Abstract: INTRODUCTION Recent studies reveal that, whereas symptomatic distal symmetric polyneuropathy is present in roughly 25% of patients with diabetes mellitus, electrophysiologic evidence of abnormal peripheral nerve function can be obtained in nearly all diabetic subjects.\" Thus, if it is assumed that neuropathy exists whenever functional abnormalities of the peripheral nerves can be demonstrated, neuropathy is the most common of the so-called \"late complications of diabetes.\" Despite its ubiquity, however, our knowledge concerning the local factors responsible for the development of nerve dysfunction in the patient with diabetes is scanty. This review is concerned with the clinical, electrophysiologic, histologic, and biochemical concomitants of diabetic distal symmetric polyneuropathy that appear to shed some light on the underlying pathogenetic mechanisms. Since the isolated single and multiple mononeuropathies associated with diabetes mellitus are thought to be a result, at least in part, of vascular lesions that result in ischemic neuropathy, such lesions will not be discussed.\