Smith Sasha, Normahani Pasha, Lane Tristan, Hohenschurz-Schmidt David, Oliver Nick, Davies Alun Huw
Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London W6 8RF, UK.
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London W6 8RF, UK.
Life (Basel). 2022 Aug 3;12(8):1185. doi: 10.3390/life12081185.
Diabetic neuropathy (DN) is a common complication of diabetes that is becoming an increasing concern as the prevalence of diabetes rapidly rises. There are several types of DN, but the most prevalent and studied type is distal symmetrical polyneuropathy, which is the focus of this review and is simply referred to as DN. It can lead to a wide range of sensorimotor and psychosocial symptoms and is a major risk factor for diabetic foot ulceration and Charcot neuropathic osteoarthropathy, which are associated with high rates of lower limb amputation and mortality. The prevention and management of DN are thus critical, and clinical guidelines recommend several strategies for these based on the best available evidence. This article aims to provide a narrative review of DN prevention and management strategies by discussing these guidelines and the evidence that supports them. First, the epidemiology and diverse clinical manifestations of DN are summarized. Then, prevention strategies such as glycemic control, lifestyle modifications and footcare are discussed, as well as the importance of early diagnosis. Finally, neuropathic pain management strategies and promising novel therapies under investigation such as neuromodulation devices and nutraceuticals are reviewed.
糖尿病性神经病变（DN）是糖尿病常见的并发症，随着糖尿病患病率迅速上升，它日益受到关注。DN有多种类型，但最常见且研究最多的类型是远端对称性多发性神经病变，这是本综述的重点，简称为DN。它可导致广泛的感觉运动和心理社会症状，是糖尿病足溃疡和夏科氏神经病变性骨关节病的主要危险因素，这些疾病与下肢截肢和死亡率的高发生率相关。因此，DN的预防和管理至关重要，临床指南基于现有最佳证据推荐了多种相关策略。本文旨在通过讨论这些指南及支持它们的证据，对DN的预防和管理策略进行叙述性综述。首先，总结DN的流行病学和多样的临床表现。然后，讨论血糖控制、生活方式改变和足部护理等预防策略，以及早期诊断的重要性。最后，综述神经病理性疼痛管理策略以及正在研究的有前景的新疗法，如神经调节装置和营养保健品。
