We are in the process of upgrading our site. Please kindly cooperate with us.
inner-banner-bg

Diabetic Neuropathy

Diabetic neuropathy (DN) is a common disorder and is defined as signs and symptoms of peripheral nerve dysfunction in a patient with diabetes mellitus (DM) in whom other causes of peripheral nerve dysfunction have been excluded. There is a higher prevalence of DM in India (4.3%) compared with the West (1%–2%). Probably Asian Indians are more prone for insulin resistance and cardiovascular mortality. The incidence of DN in India is not well known but in a study from South India 19.1% type II diabetic patients had peripheral neuropathy.  DN is one of the commonest causes of peripheral neuropathy. It accounts for hospitalisation more frequently than other complications of diabetes and also is the most frequent cause of non‐traumatic amputation. Diabetic autonomic neuropathy accounts for silent myocardial infarction and shortens the lifespan resulting in death in 25%–50% patients within 5–10 years of autonomic diabetic neuropathy. According to an estimate, two-thirds of diabetic patients have clinical or subclinical neuropathy. The diagnosis of subclinical DN requires electrodiagnostic testing and quantitative sensory and autonomic testing. All types of diabetic patients—insulin dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM), and secondary diabetic patients—can develop neuropathy. The prevalence of neuropathy increases with the duration of diabetes mellitus. In a study, the incidence of neuropathy increased from 7.5% on admission to 50% at 25 years follow up.  DSPN is the commonest type of DN and probably accounts for 75% of DNs. Many physicians incorrectly presume that DSPN is synonymous with DN. It may be sensory or motor and may involve small or large fibres, or both. Sensory impairment occurs in glove and stocking distribution and motor signs are not prominent. The sensory symptoms reach up to knee level before the fingers are involved because of length dependent dying back process. Fibre dependent axonopathy results in increased predisposition in taller people. DSPN is further classified into large fibre and small fibre neuropathy. Large fibre neuropathy is characterised by painless paresthesia with impairment of vibration, joint position, touch and pressure sensations, and loss of ankle reflex. In advanced stage, sensory ataxia may occur. Large fibre neuropathy results in slowing of nerve conduction, impairment of quality of life, and activities of daily living. Small fibre neuropathy, on the other hand, is associated with pain, burning, and impairment of pain and temperature sensations, which are often associated with autonomic neuropathy. Nerve conduction studies are usually normal but quantitative sensory and autonomic tests are abnormal. Small fibre neuropathy results in morbidity and mortality. Autonomic neuropathy is usually associated with DSPN; but diabetic autonomic neuropathy does not occur without sensory-motor neuropathy. This information can be published in our peer reviewed journal with impact factors and are calculated using citations not only from research articles but also review articles (which tend to receive more citations), editorials, letters, meeting abstracts, short communications, and case reports. The inclusion of these publications provides the opportunity for editors and publishers to manipulate the ratio used to calculate the impact factor and try to increase their number rapidly. Impact factor plays a major role for the particular journal. Journal with higher impact factor is considered to be more important than other ones.

Last Updated on: Jul 03, 2024

Related Scientific Words in Medical Sciences