Diabetes Introduction Daigram

Neuropathy is one of the most common complication of diabetes with a heterogeneous clinical presentation and a wide range of abnormalities. As a result, there is still not a single therapeutic agent for diabetic neuropathy that consistently gives more than mild relief. There is a plethora of studies in the literature indicating that metabolic, microvas-cular, and autoimmune dysfunction all play a role in the progression of diabetic neuropathy. Given the potential significance of each of these different systems in diabetes, it is not surprising that treatments targeted to specific pathways in these systems have commonly proven disappointing in their efficacy. Our "simple" concept of the various functional changes leading to peripheral nerve disease in diabetes is presented in (Fig. 1) (1). Thus, although clinical studies with thousands of patients have shown that hyperglycemia is at the center of diabetic neuropathy (2,3), finding specific biochemical pathways to manipulate for therapy has proven difficult.

From: Contemporary Diabetes: Diabetic Neuropathy: Clinical Management, Second Edition Edited by: A. Veves and R. Malik © Humana Press Inc., Totowa, NJ

Diabetes Complication Diagram
Fig. 1. Diagram of the pathologies underlying the development of diabetic neuropathy, beginning with hyperglycemia, possibly exacerbated by alcohol or smoking Adapted from ref. 1.
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