METABOLIC NEUROPATHIES

A large epidemiological study has documented that one-third of diabeti c patients have peripheral neuropathy. Diabetes duration, poor glycaem ic control, smoking and hypertension are all independent predictors of the incidence of diabetic polyneuropathy, High prevalence of autonomi c dysfunctions, both sympathetic and parasympathetic, has been found i n patients with nonalcoholic chronic liver disease. The pathogenesis o f metabolic neuropathy is unclear; even immunologic factors might play a role in the development of diabetic autonomic neuropathy, No specif ic treatments are available for these neuropathies. Correction of meta bolic derangement is fundamental, as shown by the amelioration of peri pheral nerve function obtained after successful simultaneous pancreas- kidney transplantation. The therapeuthic potentials of neurotrophins f or the prevention and treatment of diabetic neuropathy have to be conf irmed in future studies. Curr Opin Neurol 11:523-529. (C) 1998 Lippinc ott Williams & Wilkins.