| Theme |
Up-to-date renal replacement therapy for diabetic nephropathy -- Standardization and personalization |
| Title |
Prevention and management of diabetic peripheral and autonomic neuropathy |
| Author |
Jiro Nakamura |
Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine |
| Author |
Hideki Kamiya |
Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine |
| [ Summary ] |
Diabetic neuropathy is the most common complication in diabetic subjects. It presents with various clinical symptoms resulting in the deterioration of QOL and length of life. To prevent and manage diabetic neuropathy, curative treatment is vital. Treatment to care for severe symptoms is also required. Curative treatment consists of maintaining strict glycemic control and intervention based on the pathogenic mechanisms of diabetic neuropathy such as high glucose-induced metabolic deficits. Curative treatment can be adopted to care for both peripheral neuropathy and autonomic neuropathy. It should be initiated before and continued after introduction of dialysis therapy. Hypotension either during or after dialysis, due to cardiovascular autonomic neuropathy, should be carefully approached in patients with diabetic neuropathy. |