Vinik A I
Leonard Strelitz Diabetes Institutes, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk 23510, USA.
Clin Geriatr Med. 1999 May;15(2):293-320.
Estimates of the prevalence of diabetic neuropathy range from 10% to 90% of the diabetic population, depending on the criteria used to define neuropathy. Diabetic neuropathy encompasses a wide range of abnormalities affecting both the peripheral and autonomic nervous systems and causes considerable injury and death. Neurologic complications occur equally in type 1 and type 2 diabetes mellitus, as well as various forms of acquired diabetes. In this overview, we present and discuss the most recent approaches to the treatment of the common forms of diabetic neuropathy, including distal symmetric, proximal motor, and autonomic neuropathy. We also provide the reader with algorithms for recognition and management of common pain and entrapment syndromes, and a global approach to recognition of syndromes requiring specialized treatments based upon our improved understanding of their causes.
糖尿病神经病变的患病率估计在糖尿病患者群体中为10%至90%,这取决于用于定义神经病变的标准。糖尿病神经病变包括影响周围神经系统和自主神经系统的广泛异常,并导致相当大的损伤和死亡。神经并发症在1型和2型糖尿病以及各种形式的获得性糖尿病中同样会出现。在本综述中,我们展示并讨论了治疗常见形式糖尿病神经病变(包括远端对称性、近端运动性和自主神经病变)的最新方法。我们还为读者提供了识别和管理常见疼痛及卡压综合征的算法,以及基于我们对其病因的深入理解而对需要特殊治疗的综合征进行识别的整体方法。