Neuropathy in young diabetic patients

Diabetic neuropathy is one of the most common and serious complications of both type 1 and type 2 diabetes. In type 1 diabetes mellitus, neuropathy usually takes form of distal symmetric polyneuropathy (DPN) and/or diabetic autonomic neuropathy (DAN). Other forms such as acute sensory neuropathy, cranial neuropathy, truncal radiculoneuropathy or proximal motor neuropathy are present sporadically in those patients. There are three hypotheses that explain the pathogenetic mechanism of polyneuropathy: metabolic, vascular and immunological. Many diabetic patients have demonstrable abnormalities of autonomic neurological function without any evidence of clinical disease. Tests of autonomic function and tests of conduction velocity in peripheral nerves are assumed to be a measure of neurological state and may be important methods of assessing the therapy of diabetic complications. When it comes to therapeutic management, good metabolic control is essential for the prevention of diabetic neuropathy and remains the key element of treatment. Other methods (e.g. pharmacological) are used for the management of symptoms and are rarely used in the juvenile population.