Polyneuropathies in patients with diabetes mellitus

Authors: Peter Matejička;  Michal Minár
Authors‘ workplace: II. neurologická klinika LF UK a UNB, Nemocnica akad. L. Dérera, Bratislava
Published in: Forum Diab 2018; 7(3): 140-146
Category: Review Article


With an increasing prevalence of diabetes mellitus in the population predominantly of the world’s developed countries, the prevalence of complications of the primary disease linearly rises as well. One of them is diabetic neuropathy which to a large degree contributes to morbidity and indirectly also mortality related to diabetes. The term diabetic neuropathy is understood as peripheral neuropathy, caused by a direct effect of hyperglycemia engaged in a cascade of complex processes which damage the nervous fibres. The process results in the characteristic clinical picture reflecting the damage to the sensory, motor as well as autonomic peripheral nerves. The aim of this paper is not to produce a detailed analysis of the diagnosis of diabetic neuropathy, it aims to draw attention to the incidence of “non-diabetic” neuropathies in patients with diabetes mellitus. It is apparent that patients with diabetes and peripheral neuropathy are often incorrectly recorded with diabetic neuropathy, although their disorder may be autoimmunely conditioned, treatment-induced or toxic neuropathy. That is why we decided to also focus in this paper, apart from diabetic neuropathy, on the most frequently occurring peripheral neuropathies that could clinically mimic diabetic neuro­pathy, may be associated with it, or they occur along with it. These involve chronic demyelin­ation inflammatory polyneuropathy, metformin-induced neuropathy, “insulin neuritis” and alcohol neuropathy. With regard to the relatively high prevalence of the aforementioned neuropathies it is always necessary to consider their incidence also in patients with diabetes mellitus.

Key words:

antidiabetic drugs, axonal – demyelination changes, diabetes mellitus, electromyography, hyperglycemia, nervous fibres, neuropathy


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