Page 92 - The lraternational Journal of the Royal Society of Thailand.indd

The International Journal of the Royal Society of Thailand
Volume XV-2023

Revisiting Diabetic Polyneuropathy and Autonomic Neuropathy

Kongkiat Kulkantrakorn 1,2

Abstract

Polyneuropathy is the common complication from diabetes mellitus (DM).
It can lead to more severe disabilities such as neuropathic pain, imbalance,
chronic wound, and amputation. Distal symmetric sensorimotor axonal

polyneuropathy is the most common form and sometimes coexists with
autonomic neuropathy. Routine screening during regular clinic visit is a must for
early diagnosis. Many pathogenetic pathways were described and may lead to

better prevention and treatment. Currently, optimization of glucose control
and management of other vascular risk factors are recommended. Both
pharmacological and non-pharmacological measures are available for symptomatic
treatment and may modify disease progression. Further understanding in this
disease will help in improving the patient’s outcomes.

Keywords: diabetes mellitus; polyneuropathy; neuropathic pain; autonomic neuropathy

Introduction

Diabetes mellitus (DM) is the most common cause of peripheral neuropathy
worldwide. There are many forms of diabetic neuropathy which represents disorders
in nerve root (radiculopathy), plexus (plexopathy), individual nerve (mononeuropathy)

and many nerve throughout the body (polyneuropathy).

Polyneuropathy is the common complication from DM. It can lead to more
severe disabilities such as neuropathic pain, imbalance, chronic wound, and amputation.
Distal symmetric sensorimotor axonal polyneuropathy (DSPN) is the most common
form which is easily to diagnose, potentially preventable and treatable. While autonomic

neuropathy often manifests as debilitating systemic symptoms which make it harder

1 Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
2 The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand.
Correspondence to Kongkiat Kulkantrakorn (MD), Department of Internal Medicine, Faculty of Med-
icine, Thammasat University, Pathumthani, Thailand. Email: kongkiat1@gmail.com

84 Revisiting Diabetic Polyneuropathy and Autonomic Neuropathy