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Diabetic Neuropathy

  • Chapter
The Diabetic Foot

Part of the book series: Contemporary Diabetes ((CDI))

Abstract

Polyneuropathy is one of the commonest complications of the diabetes and the commonest form of neuropathy in the developed world. Diabetic polyneuropathy encompasses several neuropathic syndromes, the most common of which is distal symmetrical neuropathy, the main initiating factor for foot ulceration. The epidemiology of diabetic neuropathy has recently been reviewed in reasonable detail (1). Several clinic- (2,3) and populationbased studies (4,5) show surprisingly similar prevalence rates for distal symmetrical neuropathy, affecting about 30% of all people with diabetes. The EURODIAB prospective complications study, which involved the examination of 3250 patient with type 1 from 16 European countries, found a prevalence rate of 28% for distal symmetrical neuropathy (2). After excluding those with neuropathy at baseline, the study showed that over a 7-year period, about one-quarter of patients with type 1 diabetes developed distal symmetrical neuropathy; age, duration of diabetes, and poor glycemic control being major determinants (6). The development of neuropathy was also associated with potentially modifiable cardiovascular risk factors such as serum lipids, hypertension, body mass index, and cigaret smoking (6). Furthermore, cardiovascular disease at baseline carried a twofold risk of neuropathy, independent of cardiovascular risk factors (6). Based on recent epidemiological studies, correlates of diabetic neuropathy include increasing age, increasing duration of diabetes, poor glycemic control, retinopathy, albuminuria, and vascular risk factors (1,2,4,6). The differing clinical presentation of the several neuropathic syndromes in diabetes suggests varied etiological factors.

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  1. RoyalHallamshire Hospital, Sheffield, UK

    Solomon Tesfaye MD, FRCP (Consultant Physician and Senior Lecturer)

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  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

    Aristidis Veves MD, DSc , John M. Giurini DPM  & Frank W. Logerfo MD ,  & 

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Tesfaye, S. (2006). Diabetic Neuropathy. In: Veves, A., Giurini, J.M., Logerfo, F.W. (eds) The Diabetic Foot. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-59745-075-1_6

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