Classification for diabetic neuropathies

Diabetic neuropathies

A. Diffuse neuropathy

DSPN

Primarily small-fiber neuropathy

Primarily large-fiber neuropathy

Mixed small- and large-fiber neuropathy (most common)

Autonomic

Cardiovascular

Reduced HRV

Resting tachycardia

Orthostatic hypotension

Sudden death (malignant arrhythmia)

Gastrointestinal

Diabetic gastroparesis (gastropathy)

Diabetic enteropathy (diarrhea)

Colonic hypomotility (constipation)

Urogenital

Diabetic cystopathy (neurogenic bladder)

Erectile dysfunction

Female sexual dysfunction

Sudomotor dysfunction

Distal hypohydrosis/anhidrosis

Gustatory sweating

Hypoglycemia unawareness

Abnormal pupillary function

B. Mononeuropathy (mononeuritis multiplex) (atypical forms)

Isolated cranial or peripheral nerve (eg, CN III, ulnar, median, femoral, peroneal)

Mononeuritis multiplex (if confluent may resemble polyneuropathy)

C. Radiculopathy or polyradiculopathy (atypical forms)

Radiculoplexus neuropathy (ie, lumbosacral polyradiculopathy, proximal motor amyotrophy)

Thoracic radiculopathy

Nondiabetic neuropathies common in diabetes

Pressure palsies

Chronic inflammatory demyelinating polyneuropathy

Radiculoplexus neuropathy

Acute painful small-fiber neuropathies (treatment-induced)

CN: cranial nerve; DSPN: distal symmetric polyneuropathy; HRV: heart rate variability.

From: American Diabetes Association. Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017; 40:136. American Diabetes Association, 2017. Copyright and all rights reserved. Material from this publication has been used with the permission of American Diabetes Association.

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Classification for diabetic neuropathies