Neurol. praxi, 2012; 13(Suppl.E)

Pathophysiology of diabetic neuropathy

MUDr.Rudolf Kotas, Ph.D., prof.MUDr.Zdeněk Ambler, DrSc.

Neurologická klinika LF UK a FN Plzeň

The pathophysiology of diabetic peripheral neuropathy (DPN) is multifactorial and both vascular factors with impairment of vasa nervorum

and metabolic interactions are involved at all stages of DPN. The complex and interrelated effects of hyperglycemia include increased

metabolic flux through the polyol pathway with consequent sorbitol and fructose accumulation, reduced myoinositol and sodium-potassium

ATPase levels and altered protein kinase C activity. Accumulation of advanced glycation end-products, increased reactive oxygen

species, altered omega-6-essential fatty acids metabolism and deficit of neurotrophic factors compromise both endoneurial microvessels

and neural tissues, accelerate neuronal apoptosis and increase oxidative stress. Immunological alterations and changes in blood flow

have an influence on the nerve pathology. Vascular risk factors are also important contributors to the development of DPN.

Keywords: oxidative stress, polyol pathway, advanced glycation, omega-6-essential fatty acids, neurotrophic factors, immune mechanisms, dyslipidemia

Published: March 1, 2013  Show citation