Diabetic autonomic polyneuropathy

Abstract

Currently, about 415 million of the adult population suffer from diabetes mellitus (DM), and the number of CD patients is expected to increase to 642 million in 2040. Neuropathy is the most prevalent complication of CD, it affected 60% of patients. Diabetic autonomic polyneuropathy (DAP), a type of diabetic peripheral polyneuropathy, is frequently associated with disease duration and poor glycaemia control. DAP can affect either all organs and systems or only some of them (e.g., cardiovascular system, gastrointestinal tract, urogenital system). Cardiac autonomic neuropathy (CAN) is associated with the increase in cardiovascular morbidity and mortality. Orthostatic hypotension, a main symptom of CAN, is an independent risk factor of myocardial infarction, stroke, heart failure, arrhythmia. Treatment of DAP should be directed to both metabolic and vascular disturbances. To reach and maintain normal blood glucose level is the main goal in the prevention and impeding diabetic neuropathy. Thiamine-containing compounds, including neurobion in tablet or injection forms, can be recommended to patients with diabetic polyneuropathy as well.