Harati Y
Ann Intern Med. 1987 Oct;107(4):546-59. doi: 10.7326/0003-4819-107-4-546.
Diabetic peripheral neuropathies are a group of heterogeneous syndromes with considerable morbidity. At least 50% of diabetic patients develop one or several of these neuropathies within 25 years after the diagnosis. In recent years several pathogenetic mechanisms have been proposed, with the newest findings suggesting a link between several of these hypotheses. The hypoxic hypothesis has revived the role of vascular factors in the pathogenesis of diabetic peripheral neuropathies. Although the exact role of hyperglycemia in the development of peripheral neuropathy is not known, the balance of evidence indicates that attainment and maintenance of normal blood glucose remains the cornerstone of treatment of diabetes and diabetic neuropathies. There is no convincing evidence that any of the treatments devised to correct the metabolic derangements in nerve are of sufficient value or safety to be recommended for routine use.
糖尿病性周围神经病变是一组具有相当高发病率的异质性综合征。至少50%的糖尿病患者在诊断后25年内会出现一种或几种此类神经病变。近年来，人们提出了几种发病机制，最新研究结果表明其中几种假说之间存在联系。缺氧假说重新唤起了血管因素在糖尿病性周围神经病变发病机制中的作用。虽然高血糖在周围神经病变发展的确切作用尚不清楚，但证据表明，实现并维持正常血糖水平仍是糖尿病及糖尿病性神经病变治疗的基石。没有令人信服的证据表明，为纠正神经代谢紊乱而设计的任何治疗方法具有足够的价值或安全性，可推荐常规使用。
