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August 25, 1945


JAMA. 1945;128(17):1230-1231. doi:10.1001/jama.1945.02860340036011

Although pathologic conditions of the peripheral nerves have long been recognized, little unanimity prevails concerning the etiology and symptomatology of such conditions. So-called diabetic neuropathy has been considered by some to be the result of degenerative changes resulting from the disease of the peripheral arteries, by others the result of nutritional deficiency resulting from dietary modifications. The subject has been investigated anew by Rundles1 in the medical wards of the University Hospital of Ann Arbor, Mich. Among some 3,000 diabetic patients treated since 1936, the diagnosis of diabetic neuropathy was made in 125. Most diabetic patients who develop organic disease of the peripheral nerves have apparently had antecedent periods of grossly neglected or poorly managed treatment. The disordered metabolism of diabetes seems to be the etiologic factor in this complication. Severe polyneuropathy was precipitated, sometimes acutely, after periods of diabetic neglect, by common infections, surgical procedures and other events