The morbid anatomy of diabetic neuropathy

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Abstract
The nervous systems of 36 unselected diabetic patients were studied at autopsy and the findings were compared with those in 7 hypertensive patients. The clinical symptoms of diabetic neuropathy have an anatomical basis. The anatomical lesions are much more severe than the clinical picture would suggest. The primary lesion is in the peripheral nerves and nerve roots, with secondary changes in the spinal cord and muscles. Neurogenic atrophy of leg muscles involving small bundles is a common finding in diabetes mellitus. Correlation of nervous and vascular changes is not complete in patients with diabetes and is quite lacking in hypertensive persons. This suggests that the cause of the demyelination is not vascular.

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