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Diabetic Neuropathy

Zachary T. Bloomgarden, MD, is a practicing endocrinologist in New York, New York, and is affiliated with the Division of Endocrinology, Mount Sinai School of Medicine, New York, New York

Abbreviations: CIDP, chronic inflammatory demyelinating polyneuropathy • 5-HT, 5-hydroxytryptamine

The first 300 words of the full text of this article appear below.

Perspectives on the News commentaries are part of a free monthly CME activity. The Mount Sinai School of Medicine, New York, New York, designates this activity for 2.0 AMA PRA Category 1 credits. If you wish to participate, review this article and visit www.diabetes.procampus.net to complete a posttest and receive a certificate. The Mount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This is the seventh in a series of articles based on presentations at the American Diabetes Association's 67th Scientific Sessions, 22–26 June 2007, Chicago, Illinois, that discuss aspects of diabetic foot wounds and neuropathy.

Hyperbaric oxygen

In a debate on whether hyperbaric oxygen is beneficial in the healing of diabetic foot wounds, Anthony Berendt (Nutfield, U.K.) suggested it not to be appropriate, while Harriet Hopf (Salt Lake City, UT) argued that it is an evidence-based appropriate approach for treating certain people with severe diabetic foot wounds. As discussed in last month's column, the diabetic foot is an important problem. In a series of 449 patients with diabetic foot wounds, 352 were superficial and 134 of these were neither ischemic nor infected. A total of 183 ulcers were clinically infected, and 216 patients had arterial insufficiency. At 6 and 12 months, 247 and 295 of the ulcers had healed without amputation, with median time to healing 78 days; 6 and 8% required amputation and an additional 6 and 11% of the patients had died at the two time points, suggesting high morbidity and mortality associated with diabetic foot wounds (1). Using a Medicare database, the average expenditure for a diabetic person with a lower-extremity ulcer in 1995–1996 was over $15,000, approximatley three times that for a diabetic person without ulceration (2).

Berendt . . . [Full Text of this Article]

Types of diabetic neuropathy

Diabetic sympathetic neuropathy

Gene therapy for neuropathy and neuropathic pain

Diabetic gastroparesis

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