Evaluation and Prevention of Diabetic Neuropathy
Diabetic neuropathy is a debilitating disorder that occurs in nearly 50 percent of patients with diabetes. It is a late finding in type 1 diabetes but can be an early finding in type 2 diabetes. The primary types of diabetic neuropathy are sensorimotor and autonomic. Patients may present with only one type of diabetic neuropathy or may develop combinations of neuropathies (e.g., distal symmetric polyneuropathy and autonomic neuropathy). Distal symmetric polyneuropathy is the most common form of diabetic neuropathy. Diabetic neuropathy also can cause motor deficits, silent cardiac ischemia, orthostatic hypotension, vasomotor instability, hyperhidrosis, gastroparesis, bladder dysfunction, and sexual dysfunction. Strict glycemic control and good daily foot care are key to preventing complications of diabetic neuropathy. (Am Fam Physician 2005;71:2123-8, 2129-30. Copyright© 2005 American Academy of Family Physicians.)
ANN M. ARING, M.D., Riverside Methodist Hospital, Columbus, Ohio
DAVID E. JONES, M.D., D.P.M., Columbus, Ohio
JAMES M. FALKO, M.D., Riverside Methodist Hospital, Columbus, Ohio
Copyright © 2005 by the American Academy of Family Physicians.
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