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Diyabetik Otonom Nöropati’de Güncel Tanı ve Tedavi Yaklaşımları

Current Diagnosis and Treatment Approaches in Diabetic Autonomic Neuropathy

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DOI: 
10.5505/abantmedj.2017.48658

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Abstract (2. Language): 
Diabetic autonomic neuropathy is the most common and troublesome complication of diabetes mellitus. Though involvement of the autonomic nervous system is generally diffuse, symptoms may be confined to a single target organ or organ system. Complications of diabetic autonomic neuropathy contribute greatly to the morbidity, mortality, and reduced quality of life of the person with diabetes and are the major source of increased costs of caring for the diabetic patient. Factors in the pathogenesis of these complications are altered metabolism, vascular insufficiency, loss of growth factor trophism, and autoimmune destruction of nerves in a visceral and cutaneous distribution. The clinical manifestations and the complications of diabetic autonomic neuropathy are reviewed. Future therapeutic strategies that are developed from a better understanding of the pathogenetic processes underlying this disorder can be directed at the cause rather than the manifestations. There are studies in progress that suggest that autonomic nerves can be induced to regenerate, and the future for patients with diabetic autonomic neuropathy is brighter.
Abstract (Original Language): 
Diyabetik otonom nöropati, diyabetin en sık ve en sıkıntı verici komplikasyonudur. Otonom sinir sistemi (OSS) tutulumu genellikle diffuz olsa da, semptomlar tek bir hedef organ veya sistem ile sınırlı olabilir.Diyabetik otonom nöropatinin komplikasyonları mortalite ve morbiditede artışa, yaşam kalitesinde azalmaya ve diyabetik hastaların tedavi maliyetinde artışa sebep olmaktadır.Bu komplikasyonların patogenezindeki faktörler; metabolizmada değişme, vasküler yetersizlik, büyüme faktörlerinin trofizminde kayıp ve viseral ve kutanöz sinirlerde otoimmun destriksiyon olarak sıralanabilir. Diyabetik otonom nöropatinin komplikasyonları ve klinik manifestasyonları ile ilgili yayınlar mevcuttur. Gelecekte, hastalığın altında yatan patolojik sürecin daha iyi anlaşılması ile birlikte, tedaviler manifestasyona değil neden yönelik olabilir. Halen sürmekte olan ve otonom sinirlerin rejenerasyonunun indüklenebilir olduğu bir takım çalışmaların varlığı, diyabetik otonom nöropati hastalarının tedavisinde ümit vericidir.

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