DM neuropathy is a length-dependent axonopathy with s/s beginning in the longest nerves – feet.
DM neuronal injury factors:
- Microvascular injury
- Deposition of glycosylation end products.
- Oxidative stress
- Demyleniation(patchy compared to diffused in AIDP/CIDP)
Systemic distal sensorimotor polyneuropathy is the m/c neuropathy in DM patients and s/s depends on the nerve fibers involved.
- Small fibers – positive symptoms(pain, paresthesia, allodynia)
- Large fibers – negative symptoms(numbness, loss of proprioception/vibration, absent reflexes .)