Current Concepts in Diabetic Neuropathy
Diabetic neuropathies are classified, for the sake of convenience, into four groups. First are the distal symmetrical variety that may be predominantly motor or predominantly sensory. Second are the mononeuropathy syndromes of cranial or somatic nerves. Third are the automatic group and finally, any combination of two or three varieties. Etiopathology of these neuropathic syndromes takes into consideration the biochemical alterations and ischemic changes. The most recent understanding of the role of aldose reductase in the polyol pathway is presented briefly, as is, in the hyperglycemic state, sorbitol accumulation, which results in the decrease of AT-Pase activity and slowing of nerve conduction. In the treatment of diabetic neuropathies, aldose reductase inhibitors are being used in many centers and their release for general use is anxiously awaited.
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