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Diabetic neuropathy in childhood and adolescence

Gabriel Hajaš

Diabetic neuropathy is the group of clinic and subclinic syndromes characterized by diffused or focal lesions of peripheral somatic or autonomic nerve fibers as a result of diabetic metabolic disorder. In pediatric population there is a predominance of type 1 diabetes mellitus and diabetic neuropathy occurs in dependence of diabetes lasting and level of metabolic compensation. From the point of age there is very important the pubescent period in the development of neuropathy. In this period pathogenetic processes in the peripheral nerves very often accelerate. The most common type of diabetic neuropathy is the subclinical form, which is very important from the point of prevention. Clinical (symptomatic) forms of neuropathies are very rare in diabetic children and adolescents, from which the most frequent is the distal symetric sensorimotor polyneuropathy. Pathogenesis of diabetic neuropathy is complicated and not fully elucidated. Until now, there are unknown some specificity of the pathogenesis in childhood. The base is the long-term hyperglycemia which consequently activates cascade of pathogenetic actions. In light of population of diabetic children, the necessity of early diagnostics of neuropathy becomes even more important. There is an effort for detection of neuropathy in its earliest stage, with the possibility of immediate improvement of level of metabolic compensation in patients, with immediate start of right education of pediatric patient and his/her parents and with initiation of adequate treatment of diabetic neuropathy. According to the present knowledge of problems of early diagnostics, it is recommended for diabetic children and adolescents to be dispensarized not only by diabetologists (endocrinologists), but also by neurologists, who should do the active screening of neuropathic symptoms and signs in patients.

Ročník 2009  Témy časopisu Neurology 1 / 2009

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