Diabetes and Occipital Neuralgia

Pathophysiologic Mechanism

Small fiber neuropathy is the earliest manifestation of diabetic nerve damage, affecting 79.6-91.4% of peripheral nerve fibers and causing pain, burning, and dysesthesia, according to the American Diabetes Association 1

The American Association of Clinical Endocrinologists recommends optimizing glycemic control to prevent progression of any diabetic neuropathy, though this will not reverse existing nerve damage 2
The American Academy of Neurology suggests that the most common diabetic neuropathy pattern is distal symmetric sensorimotor polyneuropathy affecting the feet and legs, not cranial nerves, with a prevalence of focal neuropathies including cranial and truncal distributions also being well-documented in diabetes 4