Vnitr Lek 2023, 69(7):460-465 | DOI: 10.36290/vnl.2023.089

Neurological complications of diabetes mellitus

Eva Vlčková

Lékařská fakulta Masarykovy univerzity, Neurologická klinika Fakultní nemocnice Brno

The most important microvascular neurological complication of diabetes mellitus is diabetic neuropathy. In addition to the most common distal sensory or sensory-motor polyneuropathy, this term also includes autonomic neuropathy and a number of focal forms (mononeuropathy, plexopathy). Diagnosis is based on history and clinical examination; the choice of other diagnostic methods (nerve conduction studies and needle electromyography, autonomic nerve function tests, assessment of intraepidermal innervation from skin biopsy, etc.) depends on the type of nerve fibers affected. The basic intervention in the therapy and prevention of the development and progression of diabetic neuropathy is long-term optimal control of diabetes and other cardiovascular risk factors, and physical activity. In painful forms, drugs affecting neuropathic pain are also used, i.e. antiepileptics from the group of modulators of the α2δ subunit of calcium channels (gabapentin, pregabalin) and antidepressants from the group of serotonin and noradrenaline reuptake inhibitors (duloxetine, venlafaxine) or tricyclic antidepressants (amitriptyline). Thioctic acid (alpha-lipoic acid) and a number of opioids also have an analgesic effect. Diabetes mellitus is also an independent cerebrovascular risk factor and thus contributes to the development of ischaemic stroke. It also significantly increases the risk of developing cognitive impairment.

Keywords: diabetes mellitus, polyneuropathies, mononeuropathies, neuropathic pain, cerebrovascular disorders, stroke, cognitive dysfunction.

Accepted: October 19, 2023; Published: October 26, 2023  Show citation