Abstract
Diabetic patients can be affected by a wide range of peripheral nerve disorders, the rarer of which are often poorly recognised and understood. “Insulin neuritis” or “treatment induced neuropathy” is a reversible disorder characterised by acute severe distal limb pain, peripheral nerve fibre damage and autonomic dysfunction, preceded by a period of rapid glycaemic control. The condition has been reported in both type 1 and type 2 diabetics treated with insulin or oral hypoglycaemic agents who typically have a history of poor glycaemic control. Pathogenesis of the condition and its associated pain is poorly understood, with proposed mechanisms including endoneurial ischaemia, hypoglycaemic microvascular neuronal damage and regenerating nerve firing. Pain can affect other areas including the trunk and abdomen, or be more generalised. “Diabetic neuropathic cachexia” is a rare disorder associated with poor diabetic control that presents with large amounts of unintentional weight loss associated with an acute symmetrical painful peripheral neuropathy without weakness. Pain is characteristically burning in nature with predominant lower limb involvement and allodynia. The disorder can also affect type 1 and type 2 diabetics and occur irrespective of the duration of their diabetes. Depression and in males, impotence, appear to be common, although other autonomic features can be present. Typically it has a monophasic course but has been reported to be recurrent. As with insulin neuritis, this condition is reversible over weeks to months after adequate diabetic control. For both disorders, the pain can be treatment resistant despite the use of multiple analgesics.
Keywords: Cachexia, diabetes, insulin, neuropathy, neuritis, treatment
Current Diabetes Reviews
Title:Insulin Neuritis and Diabetic Cachectic Neuropathy: A Review
Volume: 9 Issue: 3
Author(s): Michael Knopp, Maithili Srikantha and Yusuf A. Rajabally
Affiliation:
Keywords: Cachexia, diabetes, insulin, neuropathy, neuritis, treatment
Abstract: Diabetic patients can be affected by a wide range of peripheral nerve disorders, the rarer of which are often poorly recognised and understood. “Insulin neuritis” or “treatment induced neuropathy” is a reversible disorder characterised by acute severe distal limb pain, peripheral nerve fibre damage and autonomic dysfunction, preceded by a period of rapid glycaemic control. The condition has been reported in both type 1 and type 2 diabetics treated with insulin or oral hypoglycaemic agents who typically have a history of poor glycaemic control. Pathogenesis of the condition and its associated pain is poorly understood, with proposed mechanisms including endoneurial ischaemia, hypoglycaemic microvascular neuronal damage and regenerating nerve firing. Pain can affect other areas including the trunk and abdomen, or be more generalised. “Diabetic neuropathic cachexia” is a rare disorder associated with poor diabetic control that presents with large amounts of unintentional weight loss associated with an acute symmetrical painful peripheral neuropathy without weakness. Pain is characteristically burning in nature with predominant lower limb involvement and allodynia. The disorder can also affect type 1 and type 2 diabetics and occur irrespective of the duration of their diabetes. Depression and in males, impotence, appear to be common, although other autonomic features can be present. Typically it has a monophasic course but has been reported to be recurrent. As with insulin neuritis, this condition is reversible over weeks to months after adequate diabetic control. For both disorders, the pain can be treatment resistant despite the use of multiple analgesics.
Export Options
About this article
Cite this article as:
Knopp Michael, Srikantha Maithili and A. Rajabally Yusuf, Insulin Neuritis and Diabetic Cachectic Neuropathy: A Review, Current Diabetes Reviews 2013; 9 (3) . https://dx.doi.org/10.2174/1573399811309030007
DOI https://dx.doi.org/10.2174/1573399811309030007 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
Call for Papers in Thematic Issues
Advancing Diabetic Wound Healing: Mechanisms and Interventions
In recent years, diabetic wounds have become a global health concern with the increase in the incidence of diabetes. Diabetic wounds are a kind of chronic and refractory ulcer. It is generally due to the microcirculatory disturbances and the reduced levels of endogenous growth factors. Delayed cutaneous wound healing is ...read more
Oxidative and inflammatory responses in the development of secondary diabetic complications
Diabetes, along with its associated secondary complications, represents a significant global health challenge, contributing significantly to morbidity and mortality. Unhealthy lifestyle habits, reduced physical activity, environmental pollutants, and stress are pivotal factors in the onset of diabetes, particularly type-2 diabetes. Poorly managed hyperglycemia can lead to various complications, including neuropathy, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Effects of Estrogen in Gender-dependent Fetal Programming of Adult Cardiovascular Dysfunction
Current Vascular Pharmacology Metabolic Fate of Endocannabinoids
Current Neuropharmacology Safety and Efficacy of Melatonin in Pediatric Migraine Prophylaxis
Current Drug Safety Mechanisms And Prevention Of TAVI-Related Cerebrovascular Events
Current Pharmaceutical Design Transformation of UPLC-MS Data Overcomes Extreme Variability in Urine Concentration and Metabolite Fold Change
Current Metabolomics Modification Strategies of Lipid-Based Nanocarriers for Mucosal Drug Delivery
Current Pharmaceutical Design Amine Oxidase Inhibitors and Development of Neuroprotective Drugs
Current Neuropharmacology Schizophrenia: A Systematic Review of the Disease State, Current Therapeutics and their Molecular Mechanisms of Action
Current Medicinal Chemistry Cyclodextrin Based Nanosponges: A Multidimensional Drug Delivery System and its Biomedical Applications
Current Drug Delivery Unmasking Sex-Based Disparity in Neuronal Metabolism
Current Pharmaceutical Design Treating COPD in Older and Oldest Old Patients
Current Pharmaceutical Design Regulation of Apoptosis by Gram-Positive Bacteria: Mechanistic Diversity and Consequences for Immunity
Current Immunology Reviews (Discontinued) Epidemiology and Etiology of Alzheimer’s disease: From Genetic to Non- Genetic Factors
Current Alzheimer Research Current Algorithms for the Diagnosis of wide QRS Complex Tachycardias
Current Cardiology Reviews Role of CGRP-Receptor Component Protein (RCP) in CLR/RAMP Function
Current Protein & Peptide Science Urotensin II: A Vascular Mediator in Health and Disease
Current Vascular Pharmacology Beneficial Effects of Corn Silk on Metabolic Syndrome
Current Pharmaceutical Design Protective Effects of Curcumin against Iron-induced Toxicity
Current Pharmaceutical Biotechnology Neurokinin-1 (NK<sub>1</sub>) receptor antagonists as possible therapeutics for psychostimulant use disorders
CNS & Neurological Disorders - Drug Targets Dexmedetomidine Use in General Anaesthesia
Current Drug Targets