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Practical Diabetes Care, 3rd Ed., Excerpt #23: Diabetic Neuropathy Part 3 of 5

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David Levy, MD, FRCP      Charcot neuroarthropathy Charcot neuroarthropathy is a serious and poorly understood condition associated with rapid destruction of bones and joints and resulting in bone fragmentation. It occurs only in patients with advanced sensory and autonomic neuropathy, and is characteristic of long-duration type 1 diabetes with other microvascular complications, …

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Practical Diabetes Care, 3rd Ed., Excerpt #22: Diabetic Neuropathy Part 2 of 5

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David Levy, MD, FRCP      Foot ulceration The ulcerated, infected and possibly gangrenous foot is a common reason for hospital admission. Anatomically, diabetic foot ulceration is restricted to the region distal to the ankle; proximal lesions are more likely ischemic, vasculitic, venous, or to have another underlying cause. Most ulcers are predominantly …

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Practical Diabetes Care, 3rd Ed., Excerpt #21: Diabetic Neuropathy Part 1 of 5

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David Levy, MD, FRCP      Introduction The devastating consequences of diabetic neuropathy are seen every day both in hospital – more bed days are taken up with the consequences of diabetic foot ulceration than any other diabetic complication – and in primary care, where sensory symptoms, especially pain, and autonomic neuropathy, especially …

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