THE EPIDEMIOLOGY OF DIABETIC NEUROPATHY

Abstract

One of the major complications of diabetes mellitus (DM) is represented by the diabetic neuropathy (DN). Different peripheral nerves may be affected through many pathological processes and, therefore, there are many types of diabetic neuropathy: distal symmetric polyneuropathy, autonomic polyneuropathy, nerve entrapment syndromes, proximal asymmetric mononeuropathy, truncal radiculopathy, cranial mononeuropathy, cronic inflammatory demyelinating polyradiculopathy. Several studies focused on the incidence and prevalence of distal polyneuropathy and cardiac autonomic neuropathy. The results differed because of the criteria for the definition of the specific terms, type of DM, duration of DM, glycemic control. Other case–control and prospective studies demonstrated a higher risk of foot ulcer in association with sensory lower limb neuropathy as measured with the 5.07 monofilament or the biothesiometer. Although the studies did not evaluate the difference between the prevalence of neuropathy between the two types of DM, it can be speculated that tight control may have a greater effect on reducing incidence of diabetic neuropathy in type 1 DM compared with type 2 DM. There is evidence that subjects with impaired glucose tolerance are at risk for the development of neuropathy. Other studies are requested in order to bring light in the field of diabetic neuropathy and its pathogenesis. It is possible that in the future all this work will lead to methods for preventing this complication of DM.