Conclusion Linking Microvessels Diabetes And Neuropathy

Compelling experimental and human work, as summarized here, has highlighted the intimate connection between microangiopathy and diabetic polyneuropathy. Epidemiological work has similarly suggested that patients with macrovascular risk factors are at greater risk of developing polyneuropathy. A number of experimental and human studies have suggested that there is a direct cause and effect relationship between diabetic microangiopathy and polyneuropathy. These have identified reduced nerve blood flow in diabetic models and possibly humans, correction of flow and nerve conduction in tandem with agents that can modify vessels, and changes of vessels in human biopsy material. However, other evidence should caution against overinterpreting such a connection. This evidence has pointed out that rigorous experimental blood flow measures and

Fig. 8. Examples of sciatic nerves from nondiabetic (left) and diabetic (right) rats perfused with India ink to outline vasa nervorum in the distal nerve stump 2 weeks following transection. Note the large number of perfused vessels in epineurial area of the nondiabetics, but fewer in diabetics. (Bar = 1 mm) (Reproduced with permission from ref. 134.)

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