BACKGROUND Treatment induced neuropathy of diabetes (TIND) is an iatrogenic painful sensory and autonomic neuropathy. Although the prevalence is not known, it is seen in up to 10% of tertiary cases referred for evaluation of diabetic neuropathy. EVIDENCE TIND is associated with a decrease in the glycosylated hemoglobin A1C in individuals with longstanding hyperglycemia. TIND is more common in individuals with type 1 diabetes, but can occur in anyone with diabetes through the use of insulin, oral hypoglycemic medications or diet control. There is an acute or subacute onset of neuropathy that is linked to the change in glucose control. Although the primary clinical manifestation is neuropathic pain there is a concurrent development of autonomic dysfunction, retinopathy and nephropathy. CONCLUSION TIND is more common than previously suspected. The number of cases reported over the past 10 years is much greater than historical literature predicted. Increased attention to target glucose control as a physician metric could suggest a possible explanation for the increased in TIND cases reported in recent years. At present, supportive care is the only recommended treatment. Future research is necessary to define the underlying mechanism, prevent development and to guide treatment recommendations.

中文翻译：

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治疗引起的糖尿病神经病变

背景治疗诱导的糖尿病神经病(TIND)是医源性疼痛感觉和自主神经病。尽管患病率尚不清楚，但在转诊用于评估糖尿病神经病变的三级病例中，高达 10% 可见。证据 TIND 与长期高血糖患者的糖化血红蛋白 A1C 降低有关。TIND 在 1 型糖尿病患者中更为常见，但通过使用胰岛素、口服降糖药物或饮食控制，任何糖尿病患者都可能发生 TIND。神经病的急性或亚急性发作与葡萄糖控制的变化有关。虽然主要的临床表现是神经性疼痛，但同时会出现自主神经功能障碍、视网膜病和肾病。结论 TIND 比以前怀疑的更常见。过去 10 年报告的病例数远远超过历史文献的预测。对目标血糖控制作为医生指标的日益关注可能暗示了近年来报告的 TIND 病例增加的可能解释。目前，支持治疗是唯一推荐的治疗方法。未来的研究对于定义潜在机制、预防发展和指导治疗建议是必要的。