General Approach to Diabetic Neuropathy

Year 2020, Volume: 4 Issue: 3, 296 - 308, 29.10.2020

Bora Uzuner , Sertaç Ketenci , Ender Salbaş

https://doi.org/10.30565/medalanya.788960

Cited By: 2

Abstract

Diabetic neuropathy (DN) is the most common complication of diabetes mellitus. It causes microvascular and macrovascular damages and diagnosis can easily be overlooked by most physicians. Generally; the diagnosis of DN can be omitted by physicians dealing with diabetes treatment since it starts with non-specific findings, shows slow progression and can be confused with complaints in many diseases. It is estimated that there will be 578 million people diagnosed with DN in the world in 2030. Chronic hyperglycemia, microvascular insufficiency, oxidative and nitrosative stress, impaired neurotropism and autoimmunity are some of the factors that cause nerve destruction. Paresthesias such as tingling, burning, electrical shock-like sensations, numbness, throbbing, compression, pinpricks to the skin, complaints are the most common symptoms. There is no treatment for pathogenetic mechanisms in diabetic neuropathy that completely eliminates neuronal damage. The purposes of treatment is slowing down the progression of the disease, controlling the pain, preventing complications, quick and adequate treatment of occurred complications, maintaining the functional capacity of the patient. In this review, we aimed to comprehensively address the general approach to diabetic neuropathy, diagnosis and treatment.

Keywords

diabetes mellitus, neuropathic pain, neuropathy, diagnosis, treatment

Diyabetik Nöropatiye Genel Yaklaşım

Abstract

Diyabetik nöropati (DN), diabetes mellitusun en yaygın komplikasyonudur. Mikro ve makrovasküler hasara neden olur ve çoğu hekim tanıyı kolaylıkla gözden kaçırabilir. Genel olarak; DN tanısı, spesifik olmayan bulgularla başladığı, yavaş ilerleme gösterdiği ve birçok hastalığa ait şikayetlerle karışabileceği için diyabet tedavisi ile uğraşan hekimler tarafından ihmal edilebilir. 2030 yılında dünyada 578 milyon kişinin DN tanısı alacağı tahmin edilmektedir. Kronik hiperglisemi, mikrovasküler yetmezlik, oksidatif ve nitrozatif stres, bozulmuş nörotropizm ve otoimmünite sinir harabiyetine neden olan faktörlerden bazılarıdır. Karıncalanma, yanma, elektrik çarpması benzeri hisler, uyuşma, zonklama, bası, deriye iğne batması gibi parestezik yakınmalar en sık görülen semptomlardır. Diyabetik nöropatide nöronal hasarı tamamen ortadan kaldıran patogenetik mekanizmaların tedavisi yoktur. Tedavinin amacı hastalığın ilerlemesini yavaşlatmak, ağrıyı kontrol altına almak, komplikasyonları önlemek, oluşan komplikasyonların hızlı ve yeterli tedavisi ve hastanın fonksiyonel kapasitesini korumaktır. Bu derlemede, diyabetik nöropati, tanı ve tedaviye genel yaklaşımı kapsamlı bir şekilde ele almayı amaçladık.

Keywords

diabetes mellitus, tanı, tedavi, nöropati, nöropatik ağrı

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