Texas Tech University Health Sciences Center, Texas, USA
Title: Diabetic Neuropathy
Dr. Piriyawat is an Associate Professor of Neurology at Texas Tech University Health Sciences Center. He completed his neurology residency at Saint Louis University where he also served as a faculty member. He joined the then newly established Department of Neurology, Texas Tech University Health Sciences Center El Paso in 2014. He was tasked to start a neurology residency program for which he has assumed the position of program director.
Diabetic neuropathy is one of the most common complications of diabetes mellitus. Presentations may be either focal (asymmetric) or generalized (symmetric); either sensory or motor or sensorimotor; either painful or painless. Autonomic nervous system can also be affected. Foot ulcers may result as a complication from diabetic neuropathy and may lead to amputations due to ischemia or infection. Studies have been conducted to gain better knowledge about pathophysiology of diabetic neuropathy and several hypotheses have been proposed. While tight glycemic control may help delay the progression of the diabetic neuropathy, medical therapy may be used for certain neuropathy-related symptoms such as neuropathic pain, erectile dysfunction and orthostatic hypotension. Patients should have their glycemic control closely monitored. Feet should be inspected daily by patients and on every visit at the physician’s office. Confocal microscopy is another useful tool in assessing the status of neuropathy.