Diabetic peripheral neuropathy (DPN) appears frequently in patients diagnosed with type 1 or type 2 diabetes ( 1-3 ). The extent of abnormalities is more pronounced if the hyperglycemia is not controlled properly ( 4, 5 ). DPN is associated with deleterious changes in peripheral nerves, such as myelin damage and decrease in nerve conduction velocity ( 4-9 ). Similar structural abnormalities and neurophysiological changes have been observed in the peripheral nerves of streptozotocin (STZ)-treated rats, an experimental model that captures many features of type 1 diabetes ( 10-12 ). As it is seen in diabetic subjects, STZtreated rats show increased morphological alterations in the myelinated fi bers of the sciatic nerve ( 13 ).Abstract Diabetic peripheral neuropathy (DPN) is characterized by myelin abnormalities; however, the molecular mechanisms underlying such defi cits remain obscure. To uncover the effects of diabetes on myelin alterations, we have analyzed myelin composition. In a streptozotocintreated rat model of diabetic neuropathy, analysis of sciatic nerve myelin lipids revealed that diabetes alters myelin's phospholipid, FA, and cholesterol content in a pattern that can modify membrane fl uidity. Reduced expression of relevant genes in the FA biosynthetic pathway and decreased levels of the transcriptionally active form of the lipogenic factor sterol-regulatory element binding factor-1c (SREBF-1c) were found in diabetic sciatic nerve. Expression of myelin's major protein, myelin protein zero (P0), was also suppressed by diabetes. In addition, we confi rmed that diabetes induces sciatic nerve myelin abnormalities, primarily infoldings that have previously been associated with altered membrane fl uidity. In a diabetic setting, synthetic activator of the nuclear receptor liver X receptor (LXR) increased SREBF-1c function and restored myelin lipid species and P0 expression levels to normal. These LXR-modulated improvements were associated with restored myelin structure in sciatic nerve and enhanced performance in functional tests such as thermal nociceptive threshold and nerve conduction velocity. These fi ndings demonstrate an important role for the LXR-SREBF-1c axis in protection from diabetes-induced myelin abnormalities .-