وصف
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ملخص
- Diabetic neuropathy, the most prevalent chronic complication of diabetes, involves peripheral nerve dysfunction after excluding other potential causes. It is crucial to differentiate diabetic neuropathy from neuropathy caused by other conditions like B12 deficiency. Different classifications of diabetic neuropathy exist, including distal symmetric polyneuropathy, autonomic neuropathy, polyradiculopathy, and mononeuropathies.
- Distal symmetric polyneuropathy is the most common type, characterized by progressive loss of sensation, while autonomic neuropathy can cause diverse symptoms like postural hypertension and gastroparesis. Treatment-induced neuropathy, though uncommon, can occur with rapid glycemic control improvements, particularly with GLP-1 agonists. This emphasizes the need to be aware of this entity, as it may be underdiagnosed.
- Prevention strategies include glucose control, though its impact varies between type 1 and type 2 diabetes. Lifestyle modifications such as maintaining normal lipids and blood pressure, achieving healthy weight, and regular exercise are essential. Foot care is crucial to prevent ulcers and amputations, with patients advised to inspect their feet daily. Safety measures like home-based exercise and evaluation are important to reduce fall risks.
- Pain management involves pharmacotherapy, with first-line options including antidepressants (SSRIs, SNRIs, tricyclics) and gabapentinoids (gabapentin, pregabalin). The choice of medication should be individualized based on patient comorbidities. Alpha lipoic acid, an antioxidant, can reduce oxidative stress and improve neuropathic symptoms, with studies suggesting a 600mg dose is optimal. Other therapies like lidocaine patches and acupuncture can also be considered.
نموذج شهادة
حول المتحدثين
د. ينال سلام
Head of Internal Medicine Department, Emirates Hospital, Jumeirah, Dubai, United Arab Emirates
الإفصاح المالي
تعليقات
تعليقات
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