Gender makes a difference in diabetic neuropathy
Background
Neuropathies are characterized by a progressive loss of nerve fibers
that can be assessed noninvasively by several tests of nerve function,
including nerve conduction studies and electromyography, quantitative
sensory testing, and autonomic function tests. A widely accepted
definition of diabetic peripheral neuropathy is "the presence of
symptoms and/or signs of peripheral nerve dysfunction in people with
diabetes after exclusion of other causes."1
Diabetic neuropathy is classified into several syndromes, each with a
distinct pattern of involvement of peripheral nerves. Patients often
have multiple or overlapping syndromes.
have been described in patients with primary (types 1 and 2) and
secondary diabetes of diverse causes, suggesting a common etiologic
mechanism based on chronic hyperglycemia. The contribution of
hyperglycemia has received strong support from the Diabetes Control and
Complications Trial (DCCT).2
The dose-dependent effect of hyperglycemia on nerves has been supported
further in recent years by increasing recognition of an association
between impaired glucose tolerance (prediabetes) and peripheral
neuropathy.3 Pathologically, numerous changes have been demonstrated in both myelinated and unmyelinated fibers.
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