The authors state that amputation in people with diabetes is associated with a low life expectancy, with an average of 2 years. In a classic study conducted with 440 diabetic patients who were followed for 25 years, an increase in clinically detectable DM was observed from 12% at the time of diabetes diagnosis to approximately 50% after 25 years, and those with the poorest control of diabetes had the highest prevalence. It is the most common cause of hospitalization than other diabetes complications and it is also the most common cause of non-traumatic amputations. Acute neuropathic pain is sometimes associated with weight loss and depression and has been referred to as diabetic neuropathic cachexia.
Diabetic amyotrophy, initially considered as a result of metabolic changes and later of ischemia, is now attributed to immunological changes. Autonomic neuropathy is often associated with autonomic diabetic neuropathic neuropathy, but diabetic autonomic neuropathy does not occur without sensory motor neuropathy. Large-fiber neuropathy causes a slowdown in nerve conduction, a deterioration in quality of life and activities of daily living. Trapping neuropathies are common in diabetic patients and cause unilateral changes in the NCV, especially in the trapped nerve segment. Diabetic neuropathy (ND) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded.
The other entrapment neuropathies in diabetic patients include the ulnar, radial and lateral femoral cutaneous nerve of the thigh, the peroneum, and the medial and lateral plantator nerves. All types of diabetic patients, insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM), and secondary diabetic patients can develop neuropathy. Early diagnosis and treatment of diabetic peripheral neuropathy can help: reduce the risk of complications. Orthostatic hypotension, tachycardia at rest, and lack of heart rate response to breathing are distinctive features of diabetic autonomic neuropathy. Cranial neuropathy in diabetic patients most commonly affects the oculomotor nerve followed by the trochlear and facial nerves, in order of frequency.
Figure 2 Proximal muscle atrophy in a 55-year-old diabetic male patient with diabetic lumbosacral radiculoplexoneuropathy.
