Diabetic neuropathies are a family of nerve disorders caused by diabetes. Diabetic neuropathies are the most common chronic complications of diabetes, with an estimated lifetime prevalence exceeding 50% in people with diabetes.
People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes.
The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight. Current studies also suggest that the risk factors for diabetic neuropathy are the duration of diabetes, age, glycosylated hemoglobin A1c (HbA1c), diabetic retinopathy (DR), smoking, and body mass Index (BMI).
The first diabetic neuropathies classification was suggested by Leyden (1893) who subdivided it in sensory and motor manifestations. Jordon and Crabtree (1935) in turn, were the first to mention pathophysiologic diabetic neuropathies mechanisms.
The most typical form of diabetic neuropathy is a chronic, distal (length-dependent) symmetrical polyneuropathy (DSPN) that accounts for about 75% of cases.
Nerve damage is likely due to a combination of factors:
metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin
Vitamin deficiencies, particularly B vitamins
neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves
Autoimmune diseases, such as rheumatoid arthritis and lupus, in which body immune system attacks its own tissues
mechanical injury to nerves, such as carpal tunnel syndrome
inherited traits that increase susceptibility to nerve disease
lifestyle factors, such as smoking or alcohol use
Family history of neuropathy
Diabetic neuropathy is a highly prevalent condition that substantially affects patients by increasing falls, causing pain and reducing quality of life. Some people with nerve damage have no symptoms at all. For others, the first symptom is often numbness, tingling, or pain in the feet.
Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time.
Diabetic neuropathy is a unique neurodegenerative disorder of the peripheral nervous system that preferentially targets sensory axons, autonomic axons and later, to a lesser extent, motor axons. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe.
Diabetic neuropathy
