PATHOGENESIS OF DIABETIC NEUROPATHY

Abstract

Diabetic neuropathy is the most common heterogeneous and debilitating microvascular complication of diabetes mellitus, which affects more than 50% of diabetic patients and is one of themajor cause of pain and mortality in patients. Diabeticneuropathic pain is that whicharises as a direct consequence of a lesion or disease affecting the somatosensory nervous system. Neuropathy is a common complication of both type 1 as well as type 2 diabetes. Diabetic peripheral neuropathy is the most prevalent peripheral neuropathy because Peripheral nerves involvement is highly frequent in diabetes mellitus and it has been documented that about one third of diabetic patients have peripheral neuropathy. Diabetic neuropathy represents a dynamic flux between neuronal degeneration and regeneration.Hyperglycemia showed the strongest evidence for diabetic neuropathy because it activate the various pathway such as- polyol pathaway, advanced glycation end products, protein kinase C, and hexosamine pathway which causes mitochondrial dysfunction and produced reactive oxygen species as well as reactive nitrogen species and decrease antioxidant enzymes such as glutathione, superoxide dismutase which ultimately generated oxidative stress and endothelial dysfunction in nerves.