ISSN: 1308-0954
Dil: Türkçe
İçerik: Özel sayılar şeklinde yayınlanır.
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Peripheric Diabetic Neuropathy
Dr. Vedia TONYUKUK GEDİK,a Dr. Özgür DEMİRa
aEndokrinoloji ve Metabolizma Hastalıkları BD, Ankara Üniversitesi Tıp Fakültesi, ANKARA
Neuropathy is the most common microvascular complication of diabetes mellitus and peripheral sensorymotor polyneuropathy is the most common neuropathy. First, it affects the distal lower extremities. As the disease progresses, sensorial loss moves proximally in the lower limbs and appears in the hands. "Stocking-glove" sensory loss is typical in this disorder. Evidence is accumulating to suggest that metabolic and ischemic factors interact with nerve repair mechanisms to cause diabetic polyneuropathy. In diabetes, a complex array of metabolic, vascular and perhaps hormonal factors shift the balance between nerve fiber damage and nerve fiber repair in favor of the former. Patients with diabetic neuropathy may present with pain, paresthesias, or dysesthesias of their feet. Loss of vibratory sensation and altered proprioception, impairment of pain, light touch and temperature, decreased or absent ankle reflexes occur. More widespread loss of reflexes and motor weakness are late findings. The need to identify simplified criteria for diagnosis has resulted in the development of two simple screening tests: one in the United Kingdom and one which developed at Michigan. There are three main elements in the treatment regimen: Glycemic control, foot care, treatment of pain. To relieve pain, antidepressant drugs (eg, duloxetine, amitriptyline), anticonvulsants (eg, pregabalin, gabapentin), alpha-lipoic acid, opioid or opioid-like drugs (eg, tramadol) can be used.Keywords: Peripheric sensorymotor polyneuropathy, glycemic control, foot care, treatment of painTurkiye Klinikleri J Endocrin-Special Topics 2008, 1(1):101-106
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