Abstract
Diabetic neuropathy (DN) is one of the commonest microvascular complication of diabetic patient. It is a heterogeneous group of disorders with distinct clinical features. Complications are proportional to both the magnitude and duration of hyperglycemia. Because symptomatology may go unnoticed for years, a good assessment will facilitate its detection. DN may manifest in several different forms: distal symmetric polyneuropathy, autonomic neuropathy, amyotrophic radiculopathy, mononeuropathy simplex and multiplex. Sensorimotor distal symmetric polyneuropathy is the most common form of neuropathy in diabetes. Typically, patients experience gradual distal numbness and joint proprioception and an increase in the pain threshold, triggering complications such as ulcers, muscle disorders or Charcot deformity. DN screening has to be performed in the moment of diagnosis (type 2 diabetes mellitus –DM–), and 5 years after diagnosis (type 1 DM); revaluation must be annual. In type 1 diabetic patients, glycemic control reduces the prevalence of DN and delay its progression; however, in type 2 neuronal loss cannot be avoided. Remaining therapeutic options are symptomatic with variable results.
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