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Related Concept Videos

Pathophysiology of Diabetes01:20

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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.
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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Related Experiment Video

Updated: Dec 30, 2025

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Diabetic neuropathy: what does the future hold?

Brian C Callaghan1,2, Gary Gallagher1, Vera Fridman3

  • 1Department of Neurology, University of Michigan, 109 Zina Pitcher Place, 4021 BSRB, Ann Arbor, MI, 48104, USA.

Diabetologia
|January 25, 2020
PubMed
Summary

Disease-modifying treatments for diabetic neuropathy are still needed. New strategies focus on obesity, dyslipidemia, and sphingolipid metabolism, with exercise showing promise for prevention and treatment.

Keywords:
DiabetesDyslipidaemiaExerciseNeuropathyObesityOpioidsPainSkin biopsySphingolipidsWeight loss

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Area of Science:

  • Neurology
  • Metabolic Medicine
  • Pharmacology

Background:

  • Diabetic neuropathy lacks effective disease-modifying treatments.
  • Glycaemic control benefits type 1 but not type 2 diabetes, the majority of patients.
  • Obesity is a significant metabolic risk factor for neuropathy, alongside diabetes.

Purpose of the Study:

  • To review emerging risk factors and mechanisms for diabetic neuropathy.
  • To explore novel disease-modifying treatment strategies.
  • To discuss current diagnostic and pain management approaches.

Main Methods:

  • Literature review of observational studies and consensus findings.
  • Analysis of emergent mechanisms like dyslipidemia and sphingolipid metabolism.
  • Evaluation of diagnostic tools and therapeutic interventions for neuropathic pain.

Main Results:

  • Obesity identified as the second leading metabolic risk factor for neuropathy.
  • Dyslipidemia and altered sphingolipid metabolism are novel mechanisms of nerve injury.
  • Exercise and weight loss are potential interventions, with stronger evidence for exercise.
  • Tricyclic antidepressants, SNRIs, and gabapentinoids are recommended for neuropathic pain, with similar efficacy and tolerability.
  • Opioid use for chronic neuropathic pain is common despite evidence of downsides and availability of guideline-recommended treatments.

Conclusions:

  • Novel therapeutic strategies for diabetic neuropathy are emerging, targeting metabolic factors.
  • Accurate diagnosis relies on clinical assessment, with newer tests under investigation.
  • Current pain management guidelines are often bypassed in favor of opioid prescriptions.