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April 9, 2003

Bariatric Surgery for Morbid Obesity

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(14):1779-1780. doi:10.1001/jama.289.14.1779-a

In Reply: In response to Drs Crawford and Hardwicke, the etiology of diabetic peripheral polyneuropathy is complex and hyperglycemia may not cause all the pathologic features in all forms of the disease.1,2 However, a great deal of clinical evidence supports hyperglycemia as being a major independent risk factor for diabetic polyneuropathy and glycemic control is a key element in its treatment.3,4 Since patients with both type 1 and 2 diabetes may experience peripheral polyneuropathy, it is unlikely that autoimmune mechanisms play a major role.

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