A new physiopathological classification of diabetic neuropathy

• Published in: Revista medíca de Chile Vol. 140; no. 12; pp. 1593 - 1605
• Main Authors: Olmos, Pablo R, Niklitschek, Sergio, Olmos, Roberto I, Faúndez, Jorge I, Quezada, Thomas A, Bozinovic, Milan A, Niklitschek, Ian A, Acosta, Jorge, Valencia, Claudio N, Bravo, Felipe A
• Format: Journal Article
• Language: Spanish
• Published: Chile 01.12.2012
• Subjects: Autonomic Nervous System Diseases - physiopathology; Diabetic Neuropathies - classification; Diabetic Neuropathies - physiopathology; Humans; Hyperglycemia - physiopathology; Peripheral Nervous System Diseases - physiopathology
• ISSN: 0034-9887; 0717-6163
• DOI: 10.4067/S0034-98872012001200012

Nowadays, Diabetic Neuropathy (DN) is considered the most common cause of peripheral neuropathy in clinical practice. It can affect sensitive, motor or autonomic nerve fibers, with symmetric, asymmetric, acute or chronic presentations. Due to this variability, with multiple physiopathologic mechanisms involved, a complex clinical classification has been used until recently. The aim of this review is to present a new classification of diabetic neuropathy, based on its physiopathology. It is divided in metabolic microvascular and hypoxic, autoimmune and inflammatory, compressive, secondary to complications of diabetes and related to treatment. It must be understood that DN is not just a functional disease, but a complication of diabetes with molecular and pathological substrates caused by hyperglycemia. Therefore, normalization of blood glucose is a fundamental step towards the successful prevention and treatment of DN.