Trotta Daniela, Verrotti Alberto, Salladini Carmela, Chiarelli Francesco
Department of Pediatrics, University of Chieti, Chieti, Italy.
Pediatr Diabetes. 2004 Mar;5(1):44-57. doi: 10.1111/j.1399-543X.2004.00041.x.
Diabetic neuropathy (DN) represents a major complication of type 1 diabetes mellitus (T1DM) but there is considerable uncertainty as to its incidence, prevalence, diagnosis and prognosis in pediatric population. Generally, DN is classified as polyneuropathy, focal neuropathy and autonomic neuropathy. The latter seems to be detectable even in asymptomatic children and adolescents with diabetes and is associated with the most serious consequences, such as hypoglycemia unawareness and cardiovascular dysfunction. A near-normal control of blood glucose in the early years after onset of diabetes may delay the development of clinically significant nerve impairment and, therefore, children and adolescents with diabetes represent a critical target for primary prevention of this complication. The aim of this review is to focus on the main clinical, epidemiological and prognostic aspects of DN in children and adolescents with T1DM. Etiopathogenetic theories and diagnostic tools are also reviewed from in a pediatric perspective.
糖尿病性神经病变（DN）是1型糖尿病（T1DM）的一种主要并发症，但在儿童人群中，其发病率、患病率、诊断及预后仍存在很大的不确定性。一般来说，DN可分为多发性神经病变、局灶性神经病变和自主神经病变。即使在无症状的糖尿病儿童和青少年中，后者似乎也可被检测到，并且与最严重的后果相关，如低血糖无意识症和心血管功能障碍。糖尿病发病后早期血糖接近正常控制可能会延缓具有临床意义的神经损伤的发展，因此，糖尿病儿童和青少年是预防这一并发症的关键目标人群。本综述的目的是聚焦于T1DM儿童和青少年DN的主要临床、流行病学及预后方面。本文还从儿科角度对病因发病机制理论和诊断工具进行了综述。
