[Diabetes mellitus-a risk factor for pain]

A high percentage of the world's population suffers from diabetes mellitus (DM). The disease leads to considerable DM-related pathological consequences and aggravates disease processes and pain as a comorbidity. This has a significant impact on the quality of life of these patients. This article describes DM-induced mechanisms that may contribute to increased pain. Diabetic patients exhibit low-grade systemic inflammation, high levels of blood glucose, and increased formation and accumulation of advanced glycation end products (AGEs). These factors can activate intracellular inflammatory signaling pathways and induce reactive oxygen species (ROS) formation, which can lead to the release of cytokines, oxidative stress, and mitochondrial dysfunction. These processes lead to increased local inflammation and damage to blood vessels and nerve fibers, which are considered to be causes of many diabetic complications. The increased release of pro-inflammatory mediators contributes to peripheral and central sensitization and thus to increased acute and chronic pain in diabetic patients. About 50% of people with DM develop diabetic neuropathy, which can cause numbness, discomfort, or severe pain. In addition, diabetic patients have an increased incidence of musculoskeletal disorders, which can cause additional pain.