Intima of epineurial arterioles is increased in diabetic polyneuropathy

Epineurial arteriolar wall components in sural nerves of 45 diabetics (39 with and six without neuropathy) were measured and compared with those of 34 healthy subjects. Intimal area and numbers of intimal nuclei were significantly greater in diabetics than in controls. Regression lines relating intimal to medial area in diabetics and controls had a common slope, but the line for diabetics was at a higher intercept. We found no direct association between increase of intima and severity of nerve fiber degeneration. These studies indicate that intima is increased in arterioles in diabetes, due primarily to proliferation of intimal cells. The increased intima, and possible resulting decrease of nerve perfusion, may contribute to development of diabetic polyneuropathy.