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A systematic review has found that diabetic peripheral neuropathy affects 30% of diabetes patients. [1] Diabetic neuropathy is implicated in 50–75% of nontraumatic amputations. The main risk factor for diabetic neuropathy is hyperglycemia. In the DCCT (Diabetes Control and Complications Trial, 1995) study, the annual incidence of neuropathy ...
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
Proximal diabetic neuropathy, also known as diabetic amyotrophy, is a complication of diabetes mellitus that affects the nerves that supply the thighs, hips, buttocks and/or lower legs. Proximal diabetic neuropathy is a type of diabetic neuropathy characterized by muscle wasting, weakness, pain, or changes in sensation/numbness of the leg.
Microvascular complications include neuropathy, nephropathy, and retinopathy; while cardiovascular disease, stroke, and peripheral vascular disease are included in the macrovascular complications. [2] The complications of diabetes can dramatically impair quality of life and cause long-lasting disability.
Due to advanced peripheral nerve dysfunction associated with diabetes (diabetic neuropathy), patients' feet have a dryness of the skin and a reduced ability to feel pain (nociception). Hence, minor injuries may remain undiscovered and subsequently progress to a full-thickness diabetic foot ulcer.
The causes of polyneuropathy can be divided into hereditary and acquired and are therefore as follows: [2] Inherited – hereditary motor neuropathies, Charcot–Marie–Tooth disease, and hereditary neuropathy with liability to pressure palsy; Acquired – diabetes mellitus, vascular neuropathy, alcohol use disorder, and vitamin B12 deficiency
The enzyme, namely aldose reductase, is also expressed in the endothelial and Schwann cells of the peripheral nervous system, contributing to diabetic neuropathy. [ 6 ] Over time, pericyte death may result in reduced capillary integrity; subsequently, there is leaking of albumin and other proteins into fluid compartments.
Acute episodes of hyperglycemia without an obvious cause may indicate developing diabetes or a predisposition to the disorder. [ citation needed ] In diabetes mellitus, hyperglycemia is usually caused by low insulin levels ( diabetes mellitus type 1 ) and/or by resistance to insulin at the cellular level ( diabetes mellitus type 2 ), depending ...
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