Diabetic Peripheral Neuropathy
In addition to retinopathy, nephropathy, and heart disease, the most common complication of diabetes is neuropathy. Diabetic peripheral neuropathy affects approximately fifty percent of patients with diabetes. This condition is characterized by pain and sensory loss that result from nerve injury. Hallmark features of diabetic peripheral neuropathy include reductions in motor and sensory nerve conduction. In addition, structural changes to peripheral nerves are observed such as axonal degeneration, Schwann cell pathology, demyelination, and endoneurial microangiopathy. Although it is believed to be a multifactorial pathology involving hyperglycemia, oxidative stress, hyperexcitability, mitochondrial dysfunction, and loss of calcium homeostasis, the molecular mechanisms that underlie diabetic peripheral neuropathy are poorly understood. Loss of neurotrophic support by Insulin, Insulin-like Growth Factors (IGF-I and IGF-II), beta-NGF, and Neurotrophin-3 is also thought to contribute to diabetes-associated neurodegeneration.