Diabetic Neurology PDF

Introduction

Diabetologists and neurologists may lead separate but parallel professional lives. Despite some instances of shared clinics and patients, the relationship between these two key subspecialties is rarely appreciated or fully utilized. This is an enormous oversight, particularly in view of the growing global burden of type 2 diabetes mellitus. Consultations involving neurological complications of diabetic patients in the emergency room setting are frequent.

In this book our intent is to bridge the gap between diabetology and neurology with a practitioner, friendly guide for the recognition, Investigation, and management of diabetic patients with neurological disease. The goal of our textbook was not to be a comprehensive textual review of diabetic neurological complications, as several excellent examples of these have recently published. We also do not cover detailed pathophysiology or all of the pharmacological considerations in this group of patients. Rather our intent is to provide a comprehensive practical review of the problems encountered at the interface of diabetes and neurology. The point form format facilitates a thorough summary of the diabetological and neurological approach to patients and their related disease states. We address the problems neurologists may encounter in diabetes patients arid the important neurological issues to consider in diabetes clinics. The emphasis is on adult patients, and some topics are deliberately covered in more than one section, depending on the context of the discussion.

Section 1 provides overviews of diabetes cant directed toward neurologists and of neurological basics directed toward diabetologisis. Of interest are abbreviated but comprehensive approaches toward the "full neurological examination." often viewed as a prohibitive and time-consuming process in diabetic clinics. We describe neurological evaluations that can be completed in a timely manner, a ctr.t saving over more expensive forms of testing that may not be necessary. We also show physicians how to expand or tailor their neurological assessments, depending on the patient's history and preliminary findings.

Section 2 provides brief point summaries of a variety of common neurological presentations. We also devote a chapter to "red flags." These are potentially serious issues that both specialties must be cognizant of.

Finally, section 3 highlights specific conditions with significant overlap between diabetes and neurology. Our final chapter presents a grouping of rare conditions, and their neurological and diabetic complication. In particular, this interesting list is expanding with newer associations being recognized yearly.

Diabetic neurology is a growing field in substantial need of increased attention at both the clinical and basic science levels. As one example, the evidence in the literature addressing the efficacy of therapies for stroke and cerebrovascular disease rarely considers diabetic patients as a separate subgroup. The important, direct central nervous system complications of diabetes, including its targeting of white matter, have only been recently recognized. Finally, diabetic neuropathy, more commonly treated in diabetes clinics than neurological clinics, lacks a safe, effective, and inexpensive therapy that arrests or reverses the disorder. Bridging the clinical divide between diabetology and neurology will help.