Diabetic neuropathy: a variety of clinical forms (lecture)
Kotov S.V., Rudakova I.G., Isakova E.V., Volchenkova Т.V.

Moscow Regional Research and Clinical Institute named after M.F. Vladimirskiy

Diabetic neuropathy takes one of the first places among complications of diabetes mellitus along with nephropathy and retinopathy. Clinical manifestations of neuropathy lead to a limitation of work capacity, social disadaptation of patients, drastically reduce the quality of life. The incidence of peripheral nervous system damage among patients with diabetes mellitus reaches 20-40% and depends on the patient's age, duration of the disease, and the severity of the violation of carbohydrate metabolism. However, the direct dependence of damage to the nervous system on the level of glycemia is not always observed. Even with the compensation for carbohydrate disorders, damage to the nervous system can be extremely deep. The damage of the autonomic nervous system is a predictor of an unfavorable prognosis, which determines the importance of an early diagnosis. Alertness of physicians towards autonomic neuropathy allows to administrate the pathogenetic therapy in the early stages of the disease and thereby to prevent severe, often fatal complications. The manifestations of autonomic neuropathy are variable. Depending on the prevalence of certain symptoms the cardiovascular, respiratory, urogenital, gastrointestinal, sudomotor and other forms are distinguished, with disturbances in the functions of individual organs and systems both in isolation and in various combinations. Cardiovascular neuropathy plays a key role in the clinic and disease prognosis, as the most important adverse factor.
Key words: autonomic neuropathy, diabetes mellitus, clinical manifestations, visual neuropathy, cranial neuropathy, tunnel neuropathies.
For citation: Kotov S.V., Rudakova I.G., Isakova E.V., Volchenkova Т.V. Diabetic neuropathy: a variety of clinical forms (lecture) // RMJ. 2017. № 11. P. 822–830.