Rinsho Shinkeigaku (Clinical Neurology)


Pathophysiology and treatment for diabetic neuropathy

Hitoshi Yasuda, M.D.

Facuty of Nursing, Shiga University of Medical Science

Diabetic neuropathy (DN) is the most frequent among peripheral neuropathies. Since its pathophysiology is so complicated, neither classification nor therapeutic management of DN has been established. Sensory/autonomic polyneuropathy (DP) is the main type of DN. Since diabetic patients occasionally have one or more subtypes of DN and/or other polyneuropathy including treatable neuropathy like CIDP, the treatment for DP has to be conducted after excluding the possibility of other conditions. Glycemic control is most essential to prevent the development of DP. However, it is practically difficult to keep HbA1c under 6.5% so that drinking and smoking better be restricted and blood pressure be properly maintained to retard the progression of DP. Aldose reductase inhibitor is only one commercially available drug for DP and its efficacy must be evaluated by nerve function tests along with subjective symptoms. More vigorous therapeutic procedure is expected by obtaining not only more potential drugs based on pathogenic mechanisms but also the technique targeting of DNA/siRNA of given peptides at dorsal root ganglion neurons.
Full Text of this Article in Japanese PDF (948K)

(CLINICA NEUROL, 49: 149|157, 2009)
key words: diabetic neuropathy, classification, pathogenic mechanism, treatment, neuropathic pain

(Received: 10-Dec-08)