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Review
. 2023 Feb 10;24(4):3554.
doi: 10.3390/ijms24043554.

Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options

Raffaele Galiero  1 , Alfredo Caturano  1 , Erica Vetrano  1 , Domenico Beccia  1 , Chiara Brin  1 , Maria Alfano  1 , Jessica Di Salvo  1 , Raffaella Epifani  1 , Alessia Piacevole  1 , Giuseppina Tagliaferri  1 , Maria Rocco  1 , Ilaria Iadicicco  1 , Giovanni Docimo  1 , Luca Rinaldi  1 , Celestino Sardu  1 , Teresa Salvatore  2 , Raffaele Marfella  1 , Ferdinando Carlo Sasso  1
Affiliations
Review

Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options

Raffaele Galiero et al. Int J Mol Sci. .

Abstract

Diabetic neuropathy (DN) is one of the main microvascular complications of both type 1 and type 2 diabetes mellitus. Sometimes, this could already be present at the time of diagnosis for type 2 diabetes mellitus (T2DM), while it appears in subjects with type 1 diabetes mellitus (T1DM) almost 10 years after the onset of the disease. The impairment can involve both somatic fibers of the peripheral nervous system, with sensory-motor manifestations, as well as the autonomic system, with neurovegetative multiorgan manifestations through an impairment of sympathetic/parasympathetic conduction. It seems that, both indirectly and directly, the hyperglycemic state and oxygen delivery reduction through the vasa nervorum can determine inflammatory damage, which in turn is responsible for the alteration of the activity of the nerves. The symptoms and signs are therefore various, although symmetrical painful somatic neuropathy at the level of the lower limbs seems the most frequent manifestation. The pathophysiological aspects underlying the onset and progression of DN are not entirely clear. The purpose of this review is to shed light on the most recent discoveries in the pathophysiological and diagnostic fields concerning this complex and frequent complication of diabetes mellitus.

Keywords: diabetic peripheral neuropathy; diagnosis; pathophysiology; type 1 diabetes mellitus; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main pathophysiological mechanisms of DPN.
See this image and copyright information in PMC

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MeSH terms

Supplementary concepts