Diabetic neuropathy, defined as
objective evidence of neural im
pairment accompanied by discern
ible symptoms, is a common
complication of diabetes.
Pathologically it is considered a
"dying back " neuropathy in
which the distal portions of the
neurons are first and more
severely affected. Both vascular
and metabolic hypotheses have
been advanced for its patho
genesis. Diabetic sensorimotor
neuropathy has two subclasses:
focal and distal symmetrical
polyneuropathy. Signs and symp
toms, complications, and guide
lines for treatment are listed for
the different syndromes. Current
research includes investigations
of the possible preventive and
therapeutic roles of glycemic
control and specific therapeutic
agents.
Fedele D., Martini A., Cardone C., et al. Impaired auditory brain-stem-evoked responses in insulin-dependent diabetic subjects. Diabetes1984;33:1085-89.
3.
Pfeifer M., Greene D.Diabetic neuropathy. In: Current concepts. Kalamazoo, Michigan: The Upjohn Company, 1985:3-59.
4.
Greene DAPfeifer MADiabetic neuropathy. In: Olefsky JM, Sherwin RS, eds. Diabetes mellitus: management and complications. New York: Churchill Livingston, 1985:223-54. (Contemporary issues in endocrinology and metabolism; vol 1).
5.
Graf RJ, Halter JB, Halar E., et al. Nerve conduction abnormalities in untreated maturity onset diabetes: relation to levels of fasting plasma glucose and glycosylated hemoglobin. Ann Intern Med1979;90:298-303.
6.
Thomas PK, Ward JD, Watkins PJDiabetic neuropathy. In: Keen H, Jarrett J, eds. Complications of diabetes . London: Edward Amold, 1982.
7.
Pirart J.Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973. Diabetes Care1978;1:168-88, 252-63.
8.
Eng GD, Hung W., August GP, et al. Nerve conduction velocity determinations in juvenile diabetes: continuing study of 190 patients. Arch Phys Med Rehabil1976;57:1-5.
9.
Ward JDAbnormal processes in the nerve. In: Brownlee M, ed. Biochemical pathology. New York : Garland Publishers, 1981:87-113. (Diabetes mellitus; vol 4.)
10.
Boulton AJ, Drury J., Clarke B., et al. Continuous subcutaneous insulin infusion in the management of painful diabetic neuropathy. Diabetes Care1982;5:386-90.
11.
DCCT Research Group. The diabetes control and complications trial (DCCT): design and methodologic considerations for the feasibility phase . Diabetes1986;35:530-45.
12.
Spencer PS, Schaumburg HHCentral-peripheral distal axonopathy: the pathology of dying-back polyneuropathies . Prog Neuropathol1976;3:253.
13.
Dolman CLThe morbid anatomy of diabetic neuropathy. Neurology1963;13:135-42.
14.
Clements RSJr. Diabetic neuropathy — new concepts of its etiology. Diabetes1979;28:604-11.
15.
Chopra JS, Hurwitz LJA comparative study of peripheral nerve conduction in diabetes and non-diabetic chronic occlusive peripheral vascular disease. Brain1969;92:83-96.
Thomas PK, Eliasson S.Diabetic neuropathy. In: Dyck PJ, Thomas PK, Lambert EH, eds. Peripheral Neuropathy. Philadelphia: WB Saunders Co, 1975:956-81.
18.
Ward JD, Barnes CG, Fisher DJ, et al. Improvement in nerve conduction following treatment in newly diagnosed diabetics. Lancet1971;1:428-30.
19.
Greene DA, Lattimer SAImpaired rat sciatic nerve sodium-potassium ATPase in acute streptozocin diabetes and its correction by dietary myo-inositol supplementation. J Clin Invest1983;72:1058-63.
20.
Greene DA, Winegrad AIEffects of acute experimental diabetes on composite energy metabolism in peripheral nerve axons and Schwann cells. Diabetes1981 ;30:967-74.
21.
Greene DA, Lattimer SAImpaired energy utilization and sodium-potassium ATPase in diabetic peripheral nerve. Am J Physiol1984;246:E311-18.
22.
Finegold D. , Lattimer SA, Nolle S., et al. Polyol pathway activity and myo-inositol metabolism: a suggested relationship in the pathogenesis of diabetic neuropathy . Diabetes1983;32:988-92.
23.
Mayhew JA, Gillon KR, Hawthorne JNFree and lipid inositol, sorbitol and sugars in sciatic nerve obtained post-mortem from diabetic and control subjects. Diabetologia1983;24:13-15.
24.
Judzewitsch RG, Jaspan JB, Polonsky KS, et al. Aldose reductase inhibition improves nerve conduction velocity in diabetic patients. N Engl J Med1983;308:119-25.
25.
Greene DA, Lattimer SAAction of sorbinil in diabetic peripheral nerve: relationship of polyol (sorbitol) pathway inhibition to a myo-inositol-mediated defect in sodium-potassium ATPase activity. Diabetes1984;33:712-16.
26.
Brown MJ, Greene DADiabetic neuropathy: pathophysiology and management. In: Asbury AK, Gilliatt RW, eds. Neurology, peripheral nerve disorders: a practical approach. Boston: Butterworths, 1984:126-54.
27.
Asbury AK, Aldredge H., Hershberg R., et al. Oculomotor palsy in diabetes mellitus: a clinicopathological study. Brain1970; 93:555-66.
28.
Brown MJ, Asbury AKDiabetic neuropathy. Ann Neurol1984;15:2-12.
29.
Longstreth G., Newcomer ADAbdominal pain caused by diabetic radiculopathy . Ann Int Med1977;86:166-68.
30.
Goodman JIFemoral neuropathy in relation to diabetes mellitus: report of 17 cases. Diabetes1954;3:266-73.
31.
Hansen S., Ballantyne JPAxonal dysfunction in the neuropathy of diabetes mellitus. A quantitative electro-physiological study. J Neurol Neurosurg Psychiatry1977;40:555-64.
32.
Winegrad AI, Morrison AD, Greene DALate complications of diabetes. In: DeGroot LJ, Cahill GH, Martini L, et al, eds. Endocrinology, vol 2. New York: Grune and Stratton, 1979:1041-60.
33.
LoGerfo FW, Coffman JDVascular and microvascular disease of the foot in diabetes. Implications for foot care. N Engl J Med1984;311:1615-19.
34.
Classen JN, Rolley RT, Carneiro R., et al. Management of foot condition of the diabetic patient. Am Surg1976;42:81-88.
35.
Boulton AJ, Franks CI, Betts RP, et al. Reduction of abnormal foot pressures in diabetic neuropathy using a new polymer insole material. Diabetes Care1984;7:42-46.
36.
Arezzo JC, Schaumburg HHThe use of the optacon as a screening device. A new technique for detecting sensory loss in individuals exposed to neurotoxins. JOM1980;22:461-64.
37.
Sinha S., Munichoodapa CS, Kozak GPNeuro-arthropathy ("Charcot joints") in diabetes mellitus: clinical study of 101 cases. Medicine (Baltimore) 1972;51:191-210.
38.
Turkington RWDepression masquerading as diabetic neuropathy . JAMA1980;243:1147-50.
39.
Byck R.Drugs and the treatment of psychiatric disorders. In: Goodman L, Gilman A, eds. Pharmacological basis of therapeutics. New York: Macmillan Publishing Co, 1975:169.
40.
Graff RJ, Halter JB, Pfeifer MA, et al. Glycemic control and nerve conduction abnormalities in noninsulin-dependent diabetic subjects. Ann Int Med1981;94:307-11.
