Oxidative stress plays a key role in the development of microvascular complications of diabetes mellitus (DM). Antioxidant enzymes protect against the rapid onset of diabetic polyneuropathy (DPN) by reducing oxidative stress. Genetic variations that affect activity or expression levels of the antioxidant enzymes may therefore be associated with susceptibility to DPN. We examined polymorphic markers Ala(-9)Val in SOD2 gene and Arg213Gly in SOD3 gene for possible relation to DPN in Russian type 1 diabetic patients. Four hundred Russian white patients with type 1 diabetes were studied using neurological examination according to recommendations of the San Antonio Conference on Diabetic Neuropathy. Two groups were formed from the general sample. Definition of frequency distribution of the polymorphic markers was performed in these groups using the polymerase chain reaction. Genes encoding the enzymes Mn-SOD and extracellular superoxide dismutase (EC-SOD) were found to be associated with the pathogenesis of DPN.

Population surveys are of high informative value and reflect the actual prevalence of diabetic polyneuropathy (DPN) in society. The purpose of the present study was to examine the spread of DPN among patients with type 1 diabetes mellitus (DM) and to assess the diagnostic value of used diagnostic methods. Three hundred and forty-six patients (100 children and adolescents and 246 adults) with type 1 DM, living in Moscow and its region were examined. The criteria adopted at the Conference on Standardization of DPN Diagnosis in Saint Antonio in 1992 were used to diagnose DPN. The criteria proposed by P. Dyck et al. were applied to define DPN stages. The prevalence of DPN in the children and adolescents was 40%, the vast majority (75%) of the patients having subclinical (la and lb) stages of DPN. Autonomic deficit was revealed in 17% of the children and adolescents with type 1 DM. In the adults, the prevalence of DPN was 66.3% with a predominance (61%) of the clinical stages (2a and 2b) stages of DPN. Autonomic deficit was detected in 25.6% of the adults with type 1 DM. The most sensitive diagnostic tests in the examination of children and adolescents were found to be a neurological examination by using the NIS-LL scale (for neuropathic disorders), as well as temperature sensitivity study, and stimulation EMG. While examining the adults, an active detection of complaints showed a high sensitivity (79%) by applying the existing scales, which makes it possible to use this method at the first stage of a diagnostic search. The study of temperature sensitivity by employing the Thioterm tool increased the diagnostic value of a neurological examination by means of the NIS-LL in all age groups.

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The effects of tanakan on the clinical picture of diabetic polyneuropathy and retinopathy, on plasma and erythrocytic membranous lipid peroxidation, on nail bed microcirculation, the electromyographic characteristics of the functional status of somatic nerves, and computer-aided perimetric parameters were investigated in 58 patients with type 2 diabetes mellitus within the framework of an open multicenter study. Tanakan was shown to be highly effective in all the studied parameters of the status of peripheral nerves and retina, microcirculation, and the degree of oxidative stress. It is concluded that tanakan may be the drug of choice in treating elderly patients with type 2 diabetes mellitus and late complications.