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Taking a Proactive Approach to Diabetic Neuropathy

Taking a Proactive Approach to Diabetic Neuropathy

According to recent estimates, diabetic neuropathy accounts for about $50 billion in both direct and indirect costs associated with diabetes in the United States. “Diabetic neuropathy is one of the most common microvascular complications of diabetes,” says Cecilia C. Low Wang, MD, FACP. “It’s associated with major morbidity and can significantly reduce quality of life for patients.” Diabetic neuropathy occurs in about 60% of patients with diabetes at some point during their lifetime and is more common in those living with diabetes for a number of years. The condition is characterized by impairment of peripheral nerve axons, particularly in the limbs. Diabetic neuropathy often results from chronic hyperglycemia, regardless of the type of diabetes. There are several different types of neuropathy that patients with diabetes may experience, but the most common forms are distal symmetric or sensorimotor diabetic peripheral neuropathy (DPN) and autonomic neuropathy. With DPN, patients typically describe their symptoms as tingling, pain, numbness, or weakness that starts out in the feet and progresses to the hands at a much later stage. With autonomic neuropathy, orthostatic hypotension, blood pressure dysregulation, urinary retention, erectile dysfunction, and gastroparesis are among the clinical consequences of autonomic dysfunction. There can also be significant hypoglycemia unawareness. Diagnostic Considerations “Early recognition and appropriate management of neuropathy in patients with diabetes are important,” says Dr. Low Wang. She notes that a number of treatment options are available for symptoms of DPN but adds that these therapies do not treat the underlying mechanisms of the disease. The American Diabetes Association notes that up to 50% of DPN cases may be asymptomatic. These patients are at risk...
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