Sahay B K, Sahay R K
Department of Endocrinology, Institute of Medical Sciences, Varanasi, India.
Neurol India. 2001 Jun;49 Suppl 1:S31-6.
Diabetes can affect the nervous system in several ways. Of all the neurological complications of diabetes, peripheral neuropathy is by far the commonest and has been extensively studied. The involvement of central nervous system can be in several forms. The underlying damage may be due to involvement of the large and small cerebral blood vessels as also due to metabolic derangement caused by prolonged hypoglycemia, anoxia or ketoacidosis. The neurological emergencies that occur in diabetes can be: 1) atherothrombotic and lacunar strokes; 2) convulsive disorder in the setting of both hypo and hyperglycemia; 3) coma; 4) cranial neuropathies; and 5) acute proximal muscle weakness. In patients with diabetes, atherothrombotic stroke is associated with poor outcome. Hyperglycemia at the time of stroke is an important risk factor for an adverse outcome than chronic stable diabetic state. Proper management of diabetes in these acute situations is crucial for a better outcome of the underlying disease process.
糖尿病可通过多种方式影响神经系统。在糖尿病的所有神经并发症中，周围神经病变是迄今为止最常见的，并且已经得到广泛研究。中枢神经系统受累可以有多种形式。潜在的损害可能是由于大脑大小血管的受累，也可能是由于长期低血糖、缺氧或酮症酸中毒引起的代谢紊乱。糖尿病中发生的神经急症可以是：1）动脉粥样硬化血栓形成性和腔隙性中风；2）低血糖和高血糖情况下的惊厥性疾病；3）昏迷；4）颅神经病变；5）急性近端肌无力。在糖尿病患者中，动脉粥样硬化血栓形成性中风预后较差。中风时的高血糖比慢性稳定糖尿病状态更是不良预后的重要危险因素。在这些急性情况下对糖尿病进行适当管理对于改善潜在疾病过程的预后至关重要。
