Cranial neuropathy as a complication of diabetes mellitus

There is a progressive increase in the incidence of diabetes mellitus worldwide. Patients with type 2 diabetes mellitus predominate significantly. Cranial neuropathy is one of the neurological complications in diabetic patients, and its clinical forms reflect the severity of diabetes. The development of cranial diabetic neuropathy dramatically reduces the quality of life of patients and leads to significant temporary disability. The frequency of cranial neuropathy in diabetes ranges from 3 to 14%, and its acute forms amount to 1%. In some cases, cranial nerve neuropathy can be detected in combination with diabetic polyneuropathy, in others - in the absence of symptoms of the latter. Clinically, there are three groups among patients with cranial diabetic neuropathy: 1) with mononeuropathy; 2) with multiple mononeuropathy, when the cranial nerves are involved in the pathological process simultaneously or sequentially; 3) with peripheral polyneuropathy and cranial neuropathy. Prolonged decompensation and inadequate treatment of diabetes are crucial in the development of cranial diabetic neuropathy. A direct dependence of cranial neuropathy on the level of glycemia, however, is not always observed. Manifestations of neuropathy can be significantly pronounced even against the compensation of carbohydrate metabolism disorders. Methods for the prevention of cranial diabetic neuropathy include: lifestyle modification, nutrition correction, reduced alcohol consumption, and smoking cessation. Lowering HbAlc levels to 6.5% or less can significantly reduce the risk of developing diabetic neuropathy and microangiopathy. The article analyzes the prevalence, main clinical manifestations, approaches to diagnosis and the basic principles of treatment of cranial diabetic neuropathy.

cranial diabetic neuropathies, diabetes mellitus