Diabetic peripheral neuropathy

Diabetic peripheral neuropathy

DPN most commonly presents as a distal, symmetric polyneuropathy. Typically feet are predominately effected (stocking distribution) and involvement of the hands comes later (stocking glove distribution). Duration and severity of hyperglycemia are major risk factors, as well as dyslipidemia, hypertension, and smoking. A small fraction of those with DPN will develop painful DPN, and of those approximately half may have spontaneous resolution in 12 months. There are some acute painful DPN syndromes associated with rapid glycemic control or in the setting of intentional or unintentional weight loss. These are potentially reversible or may have spontaneous resolution. In general, optimal glucose control is key to treatment, though tricyclic antidepressants (TCAs), serotonin reuptake inhibitors (SNRIs), and anticonvulsants all may be effective 


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