Motor Function
H. Andersen and J. Jakobsen
Introduction
Muscle Strength
Visualization and Quantification of Striated Muscle
Conclusions
Unmyelinated Nerves: Skin Biopsy and Skin Blister Methods
W.R. Kennedy and G. Wendelschafer-Crabb
Introduction
Biopsy/Blister Procedures, Staining, and Imaging
Quantitation of Nerves in a Skin Biopsy and Blister
Cutaneous Nerves in Diabetic Neuropathy
Advantages of Skin Biopsy/Blister Methods
When and Where to Biopsy/Blister
ENF Density and Sensation
Conclusion
Diabetic Sensorimotor Neuropathy: Clinical Features
Symmetric Distal Polyneuropathy
B. Neundürfer and P.K. Thomas
Definition
Clinical Picture
Differential Diagnosis
Focal and Multifocal Neuropathies
P.K. Thomas
Cranial Neuropathies
Diabetic Truncal Radiculoneuropathy
Lumbosacral Radiculoplexus Neuropathy
Focal or Multifocal Limb Neuropathies
Treatment
Central Diabetic Neuropathy
G.J. Biessels and W.H. Gispen
Cognitive Functioning
Type 1 Diabetes
Type 2 Diabetes
Diabetes, Hyperinsulinemia, and Impaired Glucose Tolerance in the Elderly
Neurophysiology Findings
Evoked Potentials
Event-Related Potentials
Structural Cerebral Changes
Pathobiochemistry
Links with Peripheral Neuropathy
Interaction with Brain Aging
Cerebrovascular Alterations
Clinical Management
Diabetic Sensorimotor Neuropathy: Treatment
Mechanisms of Neuropathic Pain
P.K. Thomas
Pain in Distal Focal or Multifocal Diabetic Neuropathy
Pain in Diabetic Polyneuropathy
Mechanisms of Pain in Diabetic Neuropathy
Nerve Trunk Pain
Dysesthetic Pain
Peripheral Blood Flow
Glycemic Control
CNS Change Secondary to Damage to the Peripheral Nervous System
Treatment of Neuropathic Pain
D. Ziegler
Introduction
Neuropathic Pain
Clinical Features of Painful Diabetic Neuropathies
Diffuse Polyneuropathies
Measures of Neuropathic Pain
Treatment of Painful Diabetic Neuropathy
Symptomatic Nonpharmacologic Treatment
Conclusions
Diabetic Autonomic Neuropathy
Cardiovascular System
V. Spallone, G. Menzinger, and D. Ziegler
Introduction
Epidemiology, Risk Factors, and Prognosis
Clinical Features
Assessment
Clinical Impact
Respiratory Tract
L. Scionti and P. Bottini
Introduction
Abnormalities of Respiration
Gastrointestinal Tract
D. O'Donovan, M. Samson, C. Feinle, K.L. Jones, and M. Horowitz
Introduction
Pathophysiology of Disordered Gut Motility
Impact of Gastrointestinal Motility on Glycemic Control
Gastrointestinal Symptoms
Conclusion
Urogenital System
C.G. Stief and D. Ziegler
Introduction
Erectile Dysfunction
Oral Agents
Local Pharmacotherapy
Vacuum Devices
Penile Reconstructive Surgery
Prosthetic Surgery
Bladder Dysfunction
Sudomotor Function
P.A. Low
Normal Sweat Response
Tests of Sudomotor Function
Pupillary Function
R.H. Straub
Introduction
Anatomy and Physiology
Pupillary Autonomic Dysfunction in Diabetic Neuropathy
Endocrine Regulation in Response to Physiologic Maneuvers
J. Hilsted and M. Taskiran
Physical Exercise
Orthostatic Hypotension
Treatment
Response to Hypoglycemia
G.B. Bolli, C.G. Fanelli, F. Porcellati, and S. Pampanelli
Introduction
Physiology of Responses to Hypoglycemia
Definition of Hypoglycemia
Pathophysiology of Hypoglycemia in Type 1 Diabetes