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Pathogenesis of Distal Symmetrical Polyneuropathy in Diabetes.

Published version
Peer-reviewed

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Authors

Normahani, Pasha 
Hohenschurz-Schmidt, David 

Abstract

Distal symmetrical polyneuropathy (DSPN) is a serious complication of diabetes associated with significant disability and mortality. Although more than 50% of people with diabetes develop DSPN, its pathogenesis is still relatively unknown. This lack of understanding has limited the development of novel disease-modifying therapies and left the reasons for failed therapies uncertain, which is critical given that current management strategies often fail to achieve long-term efficacy. In this article, the pathogenesis of DSPN is reviewed, covering pathogenic changes in the peripheral nervous system, microvasculature and central nervous system (CNS). Furthermore, the successes and limitations of current therapies are discussed, and potential therapeutic targets are proposed. Recent findings on its pathogenesis have called the definition of DSPN into question and transformed the disease model, paving the way for new research prospects.

Description

Keywords

diabetes, diabetic neuropathy, distal symmetrical polyneuropathy, neuropathic pain, pathogenesis, hyperglycemia, central nervous system, glycemic control, pain management, spinal cord stimulation

Journal Title

Life (Basel)

Conference Name

Journal ISSN

2075-1729
2075-1729

Volume Title

Publisher

MDPI AG