Diabetic neuropathy: mechanisms and future treatment options

There is no single diabetic neuropathy. A wide variety of syndromes involving the peripheral nerves may be encountered in patients with diabetes mellitus, implying a correspondingly diverse range of underlying causative mechanisms. The classification of the diabetic neuropathies is not yet finalised and has required successive modifications in the light of accumulating knowledge. The scheme favoured by myself is given in the table. This broadly categorises the manifestations into (1) rapidly reversible phenomena, (2) generalised polyneuropathies, (3) focal and multifocal neuropathies, and (4) superimposed chronic inflammatory demyelinating polyneuropathy.