Clinical Management of Diabetic Neuropathy (Contemporary Endocrinology)

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Update on the Management of Diabetic Neuropathy | Diabetes Spectrum

Need to activate? Institutional Access does not have access to this content. Open Athens. However, there are fewer opportunities with regard to the hypoalgesia, which can lead to significant morbidity by predisposing, especially in the lower extremities, to injury, ulceration, and ultimately amputation 76 , Intensive metabolic control of blood glucose reduces the incidence of new clinically detected neuropathy, but diabetes patients can still develop DPN Intensified glucose-lowering therapy increases the risk of hypoglycemic episodes and can even be dangerous 79 , There is evidence that NGF can improve hypoalgesia 81 and restore myelinated nerve fiber morphology 82 , Recently, methylglyoxal has been identified as a new target for treatment of DPN However, Ayaz et al.

What are the types of diabetic neuropathy?

CoQ10 treatment improves endothelial function and blood flow; thus, long-term treatment may be effective by improving oxygenation of the peripheral nerves Finally, Hernandez-Ojeda et al. The reason for the profound, preventive effects with CoQ10 in our studies may be the early start of the treatment, in fact essentially initiated parallel to elevation of glucose levels. The mechanisms underlying the results after CoQ10 treatment remains to be elucidated. CoQ10 treatment reduces oxidative stress and uncoupling protein 2 protein levels, as well as normalizes oxygen consumption, and prevents mitochondrial fragmentation The mice were housed, fed, and treated with CoQ The commercial basal diet contained CoQ10 was dissolved in acetone followed by impregnation of the pellets.

The left sciatic nerve was transected axotomy at midthigh level under isoflurane anesthesia, and the animals were allowed to survive for 7 d after surgery SI Text. Mechanical allodynia threshold was assessed using von Frey monofilaments, mechanical hyperalgesia using the pin-prick test, and cold allodynia by applying a drop of acetone solution SI Text. After axotomy, the onset, extent, and incidence of autotomy were recorded by using modified, previously published methods SI Text.


  1. Losing touch: diabetic peripheral neuropathy.
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For the in vitro experiments, a section of the nerve was excised and transferred into a temperature-controlled recording chamber. The distance between stimulating and recording electrodes was variable and measured with a caliper, and action currents were sampled at kHz. The CV was calculated from the time from stimulation artifact to peak of the compound action potential t 1 Fig. To compare the CV of different fiber size classes, we used measurements of t 1 and t 2 time from stimulation artifact to the trajectory-baseline crossing Fig.

Antibodies for markers used are listed in SI Text. Animals were deeply anesthetized and fixed by vascular perfusion with formalin.

The L5 DRGs were dissected, frozen, and cut in a cryostat. The sections were analyzed in a Bio-Rad Radiance Plus confocal scanning microscope. Hybridization procedure and control experiments were carried out as previously described 93 SI Text. Differences between groups were compared using Student t test two groups.

A P value less than 0. For the electrophysiological study, a factorial ANOVA was used to assess the statistical significance of the outcome of the experiments, with the two independent variables being the presence of diabetic neuropathy and CoQ10 treatment, and the dependent variable the CV. We thank Drs. Terenius Karolinska Institutet and I. Nylander Uppsala University calcitonin gene-related peptide , E. Walsh and H. NSRIF Author contributions: T. This article contains supporting information online at www. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail.

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Skip to main content. Tie-Jun Sten Shi. Contributed by Tomas G. Abstract Diabetic peripheral neuropathy DPN is the most common complication in both type 1 and type 2 diabetes. Results Metabolic Parameters. CoQ10 Prevents Hypoalgesia. Biomarker Expression in DRG. CV Decrease. Time Course.

Neuron Loss. Phenotypic Changes in DPN. DPN Treatment Strategies.

Materials and Methods Animals. Nerve Injury Model. Behavioral Tests. Western Blot Analysis. In Situ Hybridization. Statistical Analysis. Acknowledgments We thank Drs. E-mail: tiejun. The authors declare no conflict of interest. Freely available online through the PNAS open access option. Diabetes Care 28 4 : — Sima AA New insights into the metabolic and molecular basis for diabetic neuropathy.

Cell Mol Life Sci 60 11 : — J Peripher Nerv Syst 13 2 : — Zochodne DW Diabetic polyneuropathy: An update.