Understanding Diabetic Neuropathy: Focus on Oxidative Stress

Abstract

Diabetic neuropathy is one of the clinical syndromes characterized by pain and substantial morbidity primarily due to a lesion of the somatosensory nervous system. The burden of diabetic neuropathy is related not only to the complexity of diabetes but also to the poor outcomes and difficult treatment options. There is no specific treatment for diabetic neuropathy other than glycemic control and diligent foot care. Although various metabolic pathways are impaired in diabetic neuropathy, enhanced cellular oxidative stress is proposed as a common initiator. A mechanism-based treatment of diabetic neuropathy is challenging; a better understanding of the pathophysiology of diabetic neuropathy will help to develop strategies for the new and correct diagnostic procedures and personalized interventions. Thus, we review the current knowledge of the pathophysiology in diabetic neuropathy. We focus on discussing how the defects in metabolic and vascular pathways converge to enhance oxidative stress and how they produce the onset and progression of nerve injury present in diabetic neuropathy. We discuss if the mechanisms underlying neuropathy are similarly operated in type I and type II diabetes and the progression of antioxidants in treating diabetic neuropathy.

Essential Oil of Croton zehntneri Prevents Conduction Alterations Produced by Diabetes Mellitus on Vagus Nerve

“…Several studies indicate that inflammatory mechanisms and oxidative stress are important factors in the pathogenesis of DN [14][15][16][17]. Since the neuroprotective effect of EOCz does not depend on glycemic control, its mechanism of action is very likely related to its antioxidant and putative anti-inflammatory effects [20,21].…”

“…The need for new drugs for DN treatment has been investigated in several studies [11][12][13]. In the search for new treatments for DN, three major components of the physiopathology of the disease are to be stressed: pain, inflammation, and the deterioration of redox balance [14][15][16][17]. Our research team studied the plant Croton zehntneri (Euphorbiaceae), abundant in the Brazilian Caatinga, which has widespread use in folk medicine [18,19].…”

The Role of Oxidative Stress and Antioxidants in Diabetic Wound Healing

“…It is also understood that the hyperglycemia-induced polyol pathway leads to increased oxidative stress because of depletion of NADPH, which is derived from the pentose phosphate pathway that generates GSH from glutathione. Meanwhile, excess fructose, as a product in metabolism, accelerates glycation and further consumption of NADPH to aggravate intracellular oxidative stress [ 29 ]. It has been confirmed in diabetic mice with high expression of aldose reductase.…”

Association of interleukin-4 polymorphism with diabetic retinopathy and neuropathy in a Sudanese population

“…As reported by (Yeong et al 2019), IL-4 plays a critical role in neurodegeneration and neuronal death by regulating oxidative stress in neurodegenerative diseases. While it is known that diabetes mellitus induces oxidative stress with various metabolic disturbances, the exact metabolic pathway is unclear, but the most commonly proposed one is enhanced cellular oxidative stress (Pang et al 2020). In T2DM, hyperglycemia induces overproduction of reactive oxygen species, leading to damage to lipids, proteins, and DNA, which is key to the pathogenesis of diabetic neuropathy (Kasznicki et al 2012).…”