University of Michigan, Ann Arbor, MI, USA.
Lancet Neurol. 2012 Jun;11(6):521-34. doi: 10.1016/S1474-4422(12)70065-0. Epub 2012 May 16.
Diabetic peripheral neuropathy is a prevalent, disabling disorder. The most common manifestation is distal symmetrical polyneuropathy (DSP), but many patterns of nerve injury can occur. Currently, the only effective treatments are glucose control and pain management. While glucose control substantially decreases the development of neuropathy in those with type 1 diabetes, the effect is probably much smaller in those with type 2 diabetes. Evidence supports the use of specific anticonvulsants and antidepressants for pain management in patients with diabetic peripheral neuropathy. However, the lack of disease-modifying therapies for diabetic DSP makes the identification of new modifiable risk factors essential. Growing evidence supports an association between components of the metabolic syndrome, including prediabetes, and neuropathy. Studies are needed to further explore this association, which has implications for the development of new treatments for this common disorder.
糖尿病周围神经病变是一种普遍存在且使人丧失能力的疾病。最常见的表现是远端对称性多发性神经病（DSP），但也可能发生多种类型的神经损伤。目前，唯一有效的治疗方法是控制血糖和疼痛管理。虽然血糖控制在很大程度上可以降低 1 型糖尿病患者神经病变的发生，但对 2 型糖尿病患者的影响可能要小得多。有证据支持在患有糖尿病周围神经病变的患者中使用特定的抗惊厥药和抗抑郁药进行疼痛管理。然而，由于缺乏针对糖尿病 DSP 的疾病修正治疗方法，因此确定新的可修正的风险因素至关重要。越来越多的证据表明，代谢综合征的组成部分，包括前驱糖尿病，与神经病变之间存在关联。需要进行研究来进一步探讨这种关联，这对开发这种常见疾病的新治疗方法具有重要意义。
