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Diabetic neuropathy.

P J Dyck, A Windebank, H Yasuda

    Advances in Experimental Medicine and Biology
    |January 1, 1985
    PubMed
    Summary
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    Diabetic neuropathies are common in both types of diabetes, but their exact occurrence is unknown. Research suggests altered nerve microenvironments, not just high blood sugar, may cause nerve damage.

    Area of Science:

    • Neurology
    • Endocrinology
    • Epidemiology

    Background:

    • Diabetic neuropathies are common complications of both Insulin Dependent Diabetes Mellitus (IDDM) and Non-Insulin Dependent Diabetes Mellitus (NIDDM).
    • Previous studies lacked standardized methods, population-based data, and prospective designs, hindering accurate incidence and prevalence determination.
    • The direct or indirect effects of hyperglycemia on neural tissue remain unclear.

    Purpose of the Study:

    • To establish accurate incidence and prevalence rates for diabetic neuropathies.
    • To investigate the causal mechanisms linking hyperglycemia to neural dysfunction.
    • To explore the role of the nerve microenvironment in diabetic neuropathy development.

    Main Methods:

    • Initiated prospective, population-based epidemiologic studies.

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  • Employed a uniform algorithm for classifying diabetic disorders.
  • Utilized validated approaches for assessing neuropathic symptoms, deficits, and quantitative neural dysfunction endpoints.
  • Examined nerve oxygen tension and blood flow in streptozotocin-induced diabetes models.
  • Main Results:

    • Established standardized methods for diagnosing and monitoring diabetic neuropathy.
    • Observed that improved hyperglycemia control did not correlate with rapid neurologic improvement, suggesting intervening tissue alterations.
    • Found decreased nerve oxygen tension and blood flow in diabetic models, indicating microenvironmental changes.

    Conclusions:

    • Accurate incidence and prevalence of diabetic neuropathies require standardized, prospective, population-based studies.
    • Intervening tissue alterations, potentially in the nerve microenvironment, may play a significant role in diabetic neuropathy pathogenesis.
    • Further research is needed to elucidate the precise mechanisms linking metabolic changes to neural damage in diabetes.