Vinik A I, Park T S, Stansberry K B, Pittenger G L
The Strelitz Diabetes Institutes, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia 23510, USA.
Diabetologia. 2000 Aug;43(8):957-73. doi: 10.1007/s001250051477.
Diabetic neuropathy is a common complication of diabetes that is often associated both with considerable morbidity and mortality. The epidemiology and natural course of diabetic neuropathy is clouded with uncertainty, largely due to confusion regarding the definition and measurement of this disorder. The recent resurgence of interest in the vascular hypothesis, oxidative stress, the neurotrophic hypothesis and the possibility of the role of autoimmunity have opened up new avenues of investigation for therapeutic intervention. Paralleling our increased understanding of the pathogenesis of diabetic neuropathy, there must be refinements in our ability to measure quantitatively the different types of defects that occur in this disorder, so that appropriate therapies can be targeted to specific fibre types. These tests must be validated and standardised to allow comparability between studies and a more meaningful interpretation of study results. Our ability to manage successfully the many different manifestations of diabetic neuropathy depends ultimately on our success in uncovering the pathogenic processes underlying this disorder.
糖尿病性神经病变是糖尿病常见的并发症，常伴有相当高的发病率和死亡率。糖尿病性神经病变的流行病学和自然病程存在不确定性，这主要是由于对该疾病的定义和测量存在混淆。最近，人们对血管假说、氧化应激、神经营养假说以及自身免疫作用可能性的兴趣再度兴起，为治疗干预开辟了新的研究途径。随着我们对糖尿病性神经病变发病机制的深入理解，必须提高定量测量该疾病中出现的不同类型缺陷的能力，以便将适当的治疗方法靶向特定的纤维类型。这些测试必须经过验证和标准化，以便不同研究之间具有可比性，并能对研究结果进行更有意义的解读。我们成功管理糖尿病性神经病变多种不同表现的能力最终取决于我们能否成功揭示该疾病的致病过程。
