Should non-insulin-dependent diabetics with neuropathy be treated with insulin?

Neuropathy is probably the most frequent longterm complication of diabetes and may affect as many as 50% of all diabetics after 25 years’ known duration of the disease [l]. Over 80% of diabetics are non-insulin-dependent. Data on the relative frequency of neuropathy in the two types of diabetes are lacking, but it is likely that this complication is as frequent and as severe in non-insulin-dependent (NIDDM) as it is in insulin-dependent diabetes mellitus (IDDM). However, as NIDDM affects larger numbers and an older age-group, the consequences of neuropathy in terms of amputation and disability are certainly more devastating in NIDDM. The term ‘diabetic neuropathy’ refers to a multitude of neurological manifestations associated with diabetes, including the distal symmetrical polyneuropathies, focal and multi-focal mononeuropathies, and autonomic neuropathy of the