New understanding and treatment of diabetic neuropathy

IN this issue of the Journal, two specific problems in diabetic neuropathy are addressed. Said and coworkers describe the pathologic changes in sural-nerve biopsy specimens in five atypical cases of diabetic polyneuropathy.¹ They find evidence in these cases of a dying-back neuropathy affecting the longest axons. Max and coworkers² assess the relative efficacy of desipramine, amitriptyline, and fluoxetine in controlling pain in diabetic neuropathy. These articles reflect the increasing attention being given to diabetic neuropathy. This increased interest focuses on estimating the frequency, severity, and natural history of diabetic neuropathies; on their causes; on treatments that prevent or ameliorate.