Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.
King GL. Bariatric Surgery for Morbid Obesity. JAMA. 2003;289(14):1779-1780. doi:10.1001/jama.289.14.1779-a