Diabetic Peripheral Neuropathies: A Morphometric Overview

Abstract

FAZAN, S. V. P.; DE VASCONCELOS, C. C. A.; VALENÇA, M. M.; NESSLER, R. & MOORE, K. C. Diabetic peripheral neuropathies: a morphometric overview. Int. J. Morphol., 28(1):51-64, 2010. SUMMARY: Diabetes is now considered one of the main threats to human health in the 21st century and many researchers are dedicated to investigate the physiopathology of the disease, with further insights on the managements of its major complications. Since understanding the pathophysiology of the major complications of diabetes and their underlying processes is mandatory, experimental models of the disease may be useful as they allow the recognition of the early mechanisms involved in the long-term complications of diabetes. Peripheral nerve involvement is highly frequent in diabetes mellitus and it has been documented that one third of diabetic patients have peripheral neuropathy. The true prevalence is not known and reports vary from 10% to 90% in diabetic patients, depending on the criteria and methods used to define neuropathy. In this review, the most common experimental models of diabetes are presented and the pathological findings on major peripheral nerves are discussed. Also, the insights brought by morphometry to the diabetic neuropathy research are highlighted.

Exercise training enhances insulin-stimulated nerve arterial vasodilation in rats with insulin-treated experimental diabetes

“…The pathology of diabetes peripheral neuropathy is multifactorial and often studied in the context of a metabolic or vascular etiology (29). From a metabolic perspective, experimental diabetes in rats (model for Type 1 diabetes that causes chronic, severe hyperglycemia ϳ20 -40 mmol/l) results in increased nerve glucose, fructose, polyols, aldose reductase activity, protein kinase C activity, and monoenzymatic protein glycosylation as well as a reduction in nerve myoinositol and sodium potassium ATPase activity (13,15,29,32,51,63). From a vascular perspective, experimental diabetes is linked with reduced endothelial function (37, 50) and nerve blood flow (10,16,36,40,43,50,64).…”

Diabetic peripheral neuropathy assessment through corneal nerve morphometry

“…DPN affects up to 50% of the patients after 25 years of disease, being associated to 50-75% of non traumatic amputations [3,4]. The prevalence of diabetic neuropathies is dramatically increasing with the enormous burden of type-2 diabetes, but the true occurrence remains unrevealed, with variable reports in diabetic patients depending mostly on the criteria and methods used to identify neuropathy [5,6]. Frequently, patients with nerve damage have no symptoms, whilst most part have extremely painful symptoms, such as burning pain, squeezing, constricting, freezing, allodynia or non-painful neuropathic deficits, such as asleep, tingling, numbness-loss of feeling in the hands, arms, feet, and legs [3,5].…”

Factors Associated With Diabetic Neuropathy In Rats: A Systematic Review With Metanalysis

“…Malnutrition could change these neurophysiological mechanisms, as well as diabetesassociated malnutrition or non-associated, therefore it showed a new type of mixed peripheral neuropathy [5,6,7]. With regard to the vestibulocochlear nerve (VIII cranial nerve) in large magnifications, the greatest evidence was axonal atrophy and cytoplasmic intumescent (Figures 1 and 2-5).…”