Diabetic Neuropathy

Present evidence suggests that the diverse peripheral nervous syndromes associated with diabetes mellitus are not primarily the result of occlusive vascular disease. A possible exception is acute, painful, asymmetric neuropathy in older diabetic patients involving the ophthalmic, femoral, sciatic, or obturator nerve (or nerves) that may result from nerve infarcts. However, in biopsies of the radial and sural nerves from patients with the more common symmetrical distal polyneuropathy, the most conspicuous lesion is segmental demyelination, with evidence of repeated episodes of demyelination and remyelination, and abnormalities of the vasa nervorum are absent or infrequent.1 , 2 In these biopsies axonal loss and . . .