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Related Concept Videos

Diabetic Neuropathy01:22

Diabetic Neuropathy

DefinitionDiabetic neuropathy is nerve damage caused by long-standing diabetes mellitus. It results directly from prolonged high blood sugar levels.PathophysiologyThe pathophysiology of diabetic neuropathy involves both metabolic and vascular disturbances triggered by chronic hyperglycemia.Metabolic injury: Elevated glucose levels activate the polyol pathway within nerve cells, leading to the accumulation of sorbitol and fructose. This increases oxidative stress, disrupts normal nerve...
Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Diabetic Foot Ulcer01:31

Diabetic Foot Ulcer

Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory neuropathy reduces pain perception,...
Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...

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An Ultrasonic Tool for Nerve Conduction Block in Diabetic Rat Models
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Published on: October 20, 2017

Conduction slowing in diabetic sensorimotor polyneuropathy.

Samantha K Dunnigan1, Hamid Ebadi, Ari Breiner

  • 1Corresponding author: Vera Bril, vera.bril@utoronto.ca.

Diabetes Care
|September 13, 2013
PubMed
Summary

Mild demyelination is a key factor in diabetic sensorimotor polyneuropathy (DSP). Conduction slowing, particularly in type 1 diabetes, suggests improved glycemic control may be an effective intervention for DSP.

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An Ultrasonic Tool for Nerve Conduction Block in Diabetic Rat Models
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Use of In Vivo Single-fiber Recording and Intact Dorsal Root Ganglion with Attached Sciatic Nerve to Examine the Mechanism of Conduction Failure
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Use of In Vivo Single-fiber Recording and Intact Dorsal Root Ganglion with Attached Sciatic Nerve to Examine the Mechanism of Conduction Failure

Published on: August 27, 2019

Area of Science:

  • Neurology
  • Endocrinology
  • Diabetic Complications

Background:

  • Diabetic sensorimotor polyneuropathy (DSP) is a common complication of diabetes.
  • The role of mild demyelination in DSP pathophysiology is not fully understood.
  • Previous research has primarily focused on axonal damage in DSP.

Purpose of the Study:

  • To investigate the clinical and electrodiagnostic classifications of nerve injury in diabetic patients.
  • To detect evidence of nerve conduction slowing in DSP.
  • To determine the contribution of demyelination to DSP.

Main Methods:

  • Clinical examination and nerve conduction studies (NCS) were performed on 173 patients with type 1 and type 2 diabetes.
  • Patients were classified into axonal (Group A), conduction slowing (Group D), or combined (Group C) DSP based on electrodiagnostic criteria.
  • Statistical analyses included ANOVA, contingency tables, and Kruskal-Wallis tests.

Main Results:

  • 46% of patients had axonal DSP, 32% had conduction slowing DSP, and 22% had combined DSP.
  • DSP severity increased across Groups A, D, and C.
  • Subjects with conduction slowing (Group D) had higher HbA1c levels, especially those with type 1 diabetes.

Conclusions:

  • Conduction slowing is present in DSP, particularly in suboptimally controlled type 1 diabetes.
  • This suggests that improved glycemic control could be a viable intervention for this stage of DSP.
  • Demyelination may play a more significant role in DSP than previously recognized.