Peripheral Nerve Disorders: Chapter 34. Biology of diabetic neuropathy

Peripheral Nerve Disorders: Chapter 34. Biology of diabetic neuropathy
ISBN-10
0128078650
ISBN-13
9780128078655
Series
Peripheral Nerve Disorders
Category
Medical
Pages
1008
Language
English
Published
2013-08-17
Publisher
Elsevier Inc. Chapters
Authors
Eva L. Feldman, Andrea M. Vincent, Bernadette Calabek

Description

More than half of all patients with diabetes develop neuropathic disorders affecting the distal sensory and/or motor nerves, or autonomic or cranial nerve functions. Glycemic control can decrease the incidence of neuropathy but is not adequate alone to prevent or treat the disease. This chapter introduces diabetic neuropathy with a morphological description of the disease then describes our current understanding of metabolic and molecular mechanisms that contribute to neurovascular dysfunctions. Key mechanisms include glucose and lipid imbalances and insulin resistance that are interconnected via oxidative stress, inflammation, and altered gene expression. These complex interactions should be considered for the development of new treatment strategies against the onset or progression of neuropathy. Advances in understanding the combined metabolic stressors and the novel study of epigenetics suggest new therapeutic targets to combat this morbid and intractable disease affecting millions of patients with type 1 or type 2 diabetes.

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