Submit Manuscript  

Article Details


Review of Diabetic Polyneuropathy: Pathogenesis, Diagnosis and Management According to the Consensus of Egyptian Experts

[ Vol. 15 , Issue. 4 ]

Author(s):

Fahmy Amara*, Sherif Hafez, Abbas Orabi, Adel El Etriby, Aly Ahmed Abdel Rahim, Ebtissam Zakaria, Farouk Koura, Farouk Mohamed Talaat, Hanan Gawish, Ihab Attia, Mohamed Fahmy Abdel Aziz, Mohamed Hesham Mohamed Fahmy El Hefnawy, Mohamed Kamar, Mohamed Reda Halawa, Mohamed Shawky El-Sayed, Nabil Abdelfatah El Kafrawy, Samir Helmy Assaad Khalil and Samir Naem Assaad   Pages 340 - 345 ( 6 )

Abstract:


Diabetic polyneuropathy (DPN) is a complex and multifactorial entity in which various factors besides hyperglycemia play an important role. Symptoms of DPN are sensory, motor or autonomic. Intensive research proved that oxidative stress is the common denominator for the four major destructive pathways of hyperglycemia including increased hexosamine pathway flux, activation of Protein kinase-C (PKC) pathway, increased Advanced Glycated End-products (AGEs) formation, and increased Polyol Pathway flux. National data in Egypt confirms that more than 60% of Egyptian diabetic patients suffer from neuropathy. The most common complications of DPN are Cardiac Autonomic Neuropathy (CAN), diabetic foot and ulcers, neuromuscular disability, and anxiety. In addition, DPN affects the Quality of Life (QoL). According to common clinical practice, the common diagnostic tools are bed-side diagnosis and electrophysiological tests. Early diagnosis is critical to improve the prognosis of DPN and therapeutic intervention in the early phase. In this review, we provide a clear understanding of the pathogenesis, early diagnosis and the good management of DPN. Since the pathogenesis of DPN is multifactorial, its management is based on combination therapy of symptomatic; either pharmacological or non-pharmacological treatments, and pathogenic treatment. Alpha Lipoic Acid (ALA) is a potent anti-oxidant that has several advantages as a pathogenic treatment of DPN. So, in clinical practice, ALA may be prescribed for patients with early neuropathic deficits and symptoms. Patient education has an important role in the managemement of DPN.

Keywords:

Diabetic polyneuropathy, pathogenesis, prevalence, diagnosis, management, protein kinase-C.

Affiliation:

Emeritus Professor of Endocrinology, Faculty of Medicine, Alexandria University, Alexandria, Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Cairo University, Cairo, Professor of Diabetes and Endocrinology, Faculty of Medicine, Zagazig University, Al Sharqia, Professor of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Professor of Diabetes and Metabolism, Faculty of Medicine, Alexandria University, Alexandria, Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Cairo University, Cairo, Emeritus Professor of Neurology, Faculty of Medicine, Cairo University, Cairo, Professor of Neuropsychiatry, Faculty of Medicine, Alexandria University, Alexandria, Professor of Diabetes and Endocrinology Unit, Faculty of Medicine, Mansoura University, Mansoura, Professor of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Professor of Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Professor and Dean of the National Institute of Diabetes, Cairo, Professor of Diabetes and Endocrinology, Faculty of Medicine, Zagazig University, Al Sharqia, Professor of Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Professor and Head of Internal Medicine Department, Diabetes and Endocrinology Unit, Faculty of Medicine, Benha University, Benha, Member of the Egyptian National Committee of Diabetes and Professor of Internal Medicine and Diabetology, Faculty of Medicine, Menoufia University, Menoufia, Professor of Internal Medicine and Unit of Diabetology, Lipidology and Metabolism, Faculty of Medicine, Alexandria University, Alexandria, Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Alexandria University, Alexandria



Read Full-Text article