Department of Internal Medicine, Diabetology and Clinical Pharmacology, Medical University of Lodz, Poland.
Arch Med Sci. 2014 May 12;10(2):345-54. doi: 10.5114/aoms.2014.42588. Epub 2014 May 13.
Distal symmetric polyneuropathy (DSPN) is the most common chronic complication of diabetes mellitus. The pathogenesis of DSPN is not fully elucidated, but it is certainly multifactorial in nature and attributable to metabolic and microvessel disorders related to chronic hyperglycemia, diabetes duration, and several cardiovascular risk factors. Early diagnosis and appropriate management are extremely important, since up to 50% of DSPN cases may be asymptomatic, and patients are unaware of foot injury leading to foot ulcers and amputation. Simple, validated tests such as the Neuropathy Disability Score and/or Vibration Perception Threshold may be used to diagnose DSPN. Similarly, neurological dysfunction screening questionnaires should be used to assess the quality and severity of DSPN symptoms. Using both methods enables prediction of the prognosis of diabetic patients with DSPN. No causative treatment of DSPN is known, but the results of clinical trials indicate that several treatment options are highly effective in symptomatic treatment of painful DSPN. The appropriate treatment of DSPN may improve the outcome, preventing or delaying the development of numerous diabetic complications.
远端对称性多发性神经病（DSPN）是糖尿病最常见的慢性并发症。DSPN 的发病机制尚未完全阐明，但它肯定是多因素的，与慢性高血糖、糖尿病病程以及几种心血管危险因素相关的代谢和微血管紊乱有关。早期诊断和适当的管理非常重要，因为多达 50%的 DSPN 病例可能无症状，患者不知道足部损伤会导致足部溃疡和截肢。可以使用简单、经过验证的测试，如神经病变残疾评分和/或振动感觉阈值，来诊断 DSPN。同样，应使用神经病变功能障碍筛查问卷来评估 DSPN 症状的质量和严重程度。使用这两种方法可以预测患有 DSPN 的糖尿病患者的预后。目前尚不知道 DSPN 的病因治疗方法，但临床试验结果表明，几种治疗方案对治疗有症状的疼痛性 DSPN 非常有效。DSPN 的适当治疗可能会改善预后，预防或延迟多种糖尿病并发症的发生。
