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
-
ATP-Sensitive Potassium Channels
Current Pharmaceutical Design Cytoprotection and Immunomodulation in Cancer Therapy
Current Medicinal Chemistry - Anti-Cancer Agents RAAS Inhibition and Renal Protection
Current Pharmaceutical Design Sepsis, Coagulation and Anticoagulants
Endocrine, Metabolic & Immune Disorders - Drug Targets Clinical Characteristics and Treatment of Cardiomyopathies in Children
Current Cardiology Reviews Recent Advances in the Comprehension and the Management of Perioperative Systemic Host Response During Cardiopulmonary Bypass
Recent Patents on Cardiovascular Drug Discovery Effects of Flavonoids in Experimental Models of Arterial Hypertension
Current Topics in Medicinal Chemistry Natriuretic Peptide Family: New Aspects
Current Medicinal Chemistry - Cardiovascular & Hematological Agents Kounis Syndrome Following Beta-Lactam Antibiotic Use: Review of Literature
Inflammation & Allergy - Drug Targets (Discontinued) Down-Regulation of Angiogenic Inhibitors: A Potential Pathogenic Mechanism for Diabetic Complications
Current Diabetes Reviews Corticotropin Releasing Factor (CRF) Peptide Family and their Receptors: Divergent Actions Influencing Human Physiology
Current Genomics Waste Material of Propolis as a Film Forming Agent Intended to Modify the Metronidazole Release: Preparation and Characterization
Current Drug Delivery [1, 2, 4]-Oxadiazoles: Synthesis and Biological Applications
Mini-Reviews in Medicinal Chemistry Nursing Assessment, Education, and Care of Extremely Premature Neonates with Patent Ductus Arteriosus
Current Pediatric Reviews Vascular Risk Factors and Alzheimer’s Disease Pathogenesis: Are Conventional Pharmacological Approaches Protective For Cognitive Decline Progression?
CNS & Neurological Disorders - Drug Targets Schizophrenia: A Systematic Review of the Disease State, Current Therapeutics and their Molecular Mechanisms of Action
Current Medicinal Chemistry Editorial [Hot Topic: Autoimmunity (Executive Editors: D. Stahl and W. Sibrowski)]
Current Pharmaceutical Design 5-HT2A Inverse-Agonists for the Treatment of Insomnia
Current Topics in Medicinal Chemistry Redefining the Role of Long-Acting Phosphodiesterase Inhibitor Tadalafil in the Treatment of Diabetic Erectile Dysfunction
Current Diabetes Reviews Laparoscopic Surgery for Pheochromocytoma and Paraganglioma Removal: A Retrospective Analysis of Anaesthetic Management
Current Hypertension Reviews