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DiabeticPEripheralNeuropathy

DiabeticPEripheralNeuropathy - Diabetic Peripheral...

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Diabetic Peripheral Neuropathy Alyssa Crozier Prevalence: 66% of type 1 has neuropathy, 59% for type 2 diabetes Symmetric Neuroapthies Small fiber involvement (example: dysesthesias in the feet), Autonomic dysfunction (Sexual impotence), & Large fiber involvement Length dependent diabetic sensorimotor polyneuropathy (DSPN) Most common : about 55% for type 1 and 45% for type 2 Mixed neuropathy: small and large fiber sensory, autonomic, and motor nerve involvement (sensory and autonomic more common) Caused by: increased neuronal concentrations of glucose: induce conversion of glucose to sorbitol by aldose reductase using NADPH as a coenzyme Sorbitol: then leads to a sequence of events causing axonal loss and demyeliation Insufficient blood flow due to increased aldose reductase activity- results in decreased nitric oxide therefore reduced blood flow in vasa nervorum Diagnosis: Symptoms/signs of neuropathy, abnormal EDx studies, quantitative sensation test abnormalities, heart rate decrease with deep breathing or Valsalva maneuver
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