Diabetic Neuropathy: A Position Statement by the American Diabetes Association
By Rodica Pop-Busui, A. Boulton, Eva L. Feldman, V. Bril, R. Freeman, R. Malik, J. Sosenko, Dan Ziegler. Diabetes Care, 2016
2,212 citations recorded by the source corpus.
Diabetic neuropathies are the most prevalent chronic complications of diabetes. This heterogeneous group of conditions affects different parts of the nervous system and presents with diverse clinical manifestations. The early recognition and appropriate management of neuropathy in the patient with diabetes is important for a number of reasons: 1. Diabetic neuropathy is a diagnosis of exclusion. Nondiabetic neuropathies may be present in patients with diabetes and may be treatable by specific measures. 2. A number of treatment options exist for symptomatic diabetic neuropathy. 3. Up to 50% of diabetic peripheral neuropathies may be asymptomatic. If not recognized and if preventive foot care is not implemented, patients are at risk for injuries to their insensate feet. 4. Recognition and treatment of autonomic neuropathy may improve symptoms, reduce sequelae, and improve quality of life. Among the various forms of diabetic neuropathy, distal symmetric polyneuropathy (DSPN) and diabetic autonomic neuropathies, particularly cardiovascular autonomic neuropathy (CAN), are by far the most studied (1–4). There are several atypical forms of diabetic neuropathy as well (1–4). Patients with prediabetes may also develop neuropathies that are similar to diabetic neuropathies (5–10). Table 1 provides a comprehensive classification scheme for the diabetic neuropathies. View this table: Table 1 Classification for diabetic neuropathies Due to a lack of treatments that target the underlying nerve damage, prevention is the key component of diabetes care. Screening for symptoms and signs of diabetic neuropathy is also critical in clinical practice, as it may detect the earliest stages of neuropathy, enabling early intervention. Although screening for rarer atypical forms of diabetic neuropathy may be warranted, DSPN and autonomic neuropathy are the most common forms encountered in practice. The strongest available evidence regarding treatment pertains to these forms. This Position Statement is based on several recent technical reviews, to which the reader is referred for detailed discussion …
Subfields: Endocrinology, Diabetes and Metabolism, Neurology, Physiology
View Paper: https://www.semanticscholar.org/paper/6e472108325fdb6b6f32f66274d1bbf14d406132
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In Endocrinology, Diabetes and Metabolism
Citations in the corpus
- Standards of medical care for type 2 diabetes in China 2019 (2019, methodology): “If the above examinations cannot be confirmed, differential diagnosis is needed and can be done by electromyography.(4,121,122) The diagnostic flowchart of DPSN is shown in Figure 4.”
- Diabetes and Hypertension: A Position Statement by the American Diabetes Association (2017, background): “Orthostatic Hypotension Diabetic autonomic neuropathy or volume depletion can cause orthostatic hypotension (35), which may be further exacerbated by antihypertensive medications.”