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Classification for diabetic neuropathies

Classification for diabetic neuropathies
Diabetic neuropathies
A. Diffuse neuropathy
  • DSPN
  • Primarily small-fiber neuropathy
  • Primarily large-fiber neuropathy
  • Mixed small- and large-fiber neuropathy (most common)
  • Autonomic
  • Cardiovascular
  • Reduced HRV
  • Resting tachycardia
  • Orthostatic hypotension
  • Sudden death (malignant arrhythmia)
  • Gastrointestinal
  • Diabetic gastroparesis (gastropathy)
  • Diabetic enteropathy (diarrhea)
  • Colonic hypomotility (constipation)
  • Urogenital
  • Diabetic cystopathy (neurogenic bladder)
  • Erectile dysfunction
  • Female sexual dysfunction
  • Sudomotor dysfunction
  • Distal hypohydrosis/anhidrosis
  • Gustatory sweating
  • Hypoglycemia unawareness
  • Abnormal pupillary function
B. Mononeuropathy (mononeuritis multiplex) (atypical forms)
  • Isolated cranial or peripheral nerve (eg, CN III, ulnar, median, femoral, peroneal)
  • Mononeuritis multiplex (if confluent may resemble polyneuropathy)
C. Radiculopathy or polyradiculopathy (atypical forms)
  • Radiculoplexus neuropathy (ie, lumbosacral polyradiculopathy, proximal motor amyotrophy)
  • Thoracic radiculopathy
Nondiabetic neuropathies common in diabetes
  • Pressure palsies
  • Chronic inflammatory demyelinating polyneuropathy
  • Radiculoplexus neuropathy
  • Acute painful small-fiber neuropathies (treatment-induced)
CN: cranial nerve; DSPN: distal symmetric polyneuropathy; HRV: heart rate variability.
From: American Diabetes Association. Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017; 40:136. American Diabetes Association, 2017. Copyright and all rights reserved. Material from this publication has been used with the permission of American Diabetes Association.
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