896 9 archive 2 disk0/00/00/08/96 2007-10-19 13:03:25 2007-10-31 18:24:49 2007-10-19 13:03:25 article show Azman Ali Raymond Universiti Kebangsaan Malaysia, Dept. of Medicine pub R none Diabetes Mellitus, Neuropathy, Management Diabetes mellitus is the commonest cause of neuropathy worldwide. Diabetic neuropathy (DN) develops in about 4-10% of diabetic patients after 5 years and in 15% after 20 years.Four main mechanisms have been postulated to underlie the pathogenesis of DN. Diabetic neuropathy can be divided into symmetrical and asymmetrical neuropathies. Diabetic Autonomic Neuropathy (DAN) parallels the severity of DSN, and affects primarily the cardiovascular, gastrointestinal, genitourinary and integumentary systems. The cornerstone of treatment of diabetic neuropathy is optimization of glycaemic control. Future treatments for diabetic neuropathy should address the underlying pathogenesis. 2003-07 published Malaysian Journal of Medical Sciences 10 2 School of Medical Sciences, Kubang Kerian, Universiti Sains Malaysia 27-30 TRUE 1394195X http://www.medic.usm.my/publication/mjms/ 1. Martyn C.N., Hughes R.A. Epidemiology of peripheral neuropathy. J Neurol Neurosurgery Psychiatry 1997;62:310-8. 2. Bosch E.P., Smith B.E. Disorders of the Peripheral Nerve. In: Bradley WG, Daroff RB, Fenichel GM, Marsden CD, eds. Neurology in Clinical Practice Third Edition. Oxford: Butterworth-Heinemann, 2000; 2045-130. 3. Thomas P.K. Classification, differential diagnosis, and staging of diabetic neuropathy. Diabetes 1997; 46 Suppl 2: S54-S57. 4. Anand P. Neurotrophins and peripheral neuropathy. Phil Trans R Soc London 1996; 351: 449-54. 5. Dyck P.J., Giannini C. Pathologic alterations in the diabetic neuropathies of humans: a review. J Neuropathol Exp Neurol 1997; 55: 1181-93. 6. Diabetes Control and Complication Trial Research Group. The effect of intensive diabetes therapy on the development and progression of neuropathy. Ann Intern Med 1995; 122: 561-8. 7. Krendel D.A., Costigan D.A., Hopkins L.C. Successful treatment of neuropathies in patients with diabetes mellitus. Arch Neurol 1995; 52: 1063-61. 8. Low P.A., Gilden J.L., Freeman R, et al. Efficacy of midodrine vs. placebo in neurogenic orthostatic hypotension. A randomised, double-blind multicenter study. Midodrine study group. JAMA 1997; 277: 1046-51. 9. Apfel S.C., Kessler J.A., Adornato B.T., et al. Recombinanthuman nerve growth factor in the treatment of diabetic polyneuropathy. Neurology 1998; 51: 695-702. 10. Ziegler D., Gries F.A. Alpha-lipoic acid in the treatment of diabetic peripheral and cardiac autonomic neuropathy. Diabetes 1997; 46 Suppl 2: S62-S66. 11. Nelson K.A., Park K.M., Roinovitz E., et al. High-dose oral dextromethorphan versus placebo in painful diabetic neuropathy and postherpetic neuralgia. Neurology 1997: 48: 1212-8. 12. Horrobin D.F. Essential fatty acids in the management of impaired nerve function in diabetes. Diabetes 1997; 46 Suppl 2: S90-S93.