Diabetic polyneuropathy: pathogenesis, classification, clinical presentation, and treatment

• Main Authors: Marina Valentinovna Nesterova, V V Galkin
• Format: Article
• Language: Russian
• Published: IMA-PRESS LLC 2013-11-01
• Series: Nevrologiâ, Nejropsihiatriâ, Psihosomatika
• Subjects: diabetes mellitus; diabetic polyneuropathy; painful syndrome
• Online Access: https://nnp.ima-press.net/nnp/article/view/201

Diabetes mellitus (DM) is a global epidemic followed by late complications as diabetic polyneuropathy (DPN) and diabetic foot syndrome, leading to appreciable social and economic consequences. Virtually all patients with DM develop DPN in different periods. There is a clear correlation between the presence and magnitude of painful DPN and the duration of DM and the level of glycosylated hemoglobin and the severity of DPN. In spite of the abundance of theories of the development of DPN, its main identified pathogenetic factor is hyperglycemia. The literature gives no universal classification due to the variability of clinical symptoms. The main goals of treatment are to affect the pathogenesis of the disease and to prescribe symptomatic medications. The pathogenetic treatment of DPN includes compensation for carbohydrate metabolism and use of neurometabolic drugs. Pain from DPN may be controlled with antidepressants, anticonvulsants, local anesthetics and opioid analgesics. Although much evidence for the pathogenesis of peripheral nervous system injury has been recently accumulated, a universal standard for the effective therapy of DPN and the follow-up of these patients has not yet been developed.