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Review
. 2024 Jun 6;23(2):1589-1600.
doi: 10.1007/s40200-024-01447-x. eCollection 2024 Dec.

Diabetic neuropathy: understanding the nexus of diabetic neuropathy, gut dysbiosis and cognitive impairment

Divya Durai Babu  1 , Seema Mehdi  1 , Kamsagara Linganna Krishna  1 , Mankala Sree Lalitha  1 , Chethan Konasuru Someshwara  1 , Suman Pathak  2 , Ujwal Reddy Pesaladinne  1 , Rahul Kinnarahalli Rajashekarappa  1 , Prakruthi Shivakumari Mylaralinga  1
Affiliations
Review

Diabetic neuropathy: understanding the nexus of diabetic neuropathy, gut dysbiosis and cognitive impairment

Divya Durai Babu et al. J Diabetes Metab Disord. .

Abstract

Objectives: Diabetic neuropathy is a traditional and one of the most prevalent complications of diabetes mellitus. The exact pathophysiology of diabetic neuropathy is not fully understood. However, oxidative stress and inflammation are proven to be one of the major underlying mechanisms of neuropathy which is described in detail. Gut dysbiosis is being studied for various neurological disorders and its impact on diabetic neuropathy is also explained. Diabetic neuropathy also causes loss in an individual's quality of life and one such adverse event is cognitive dysfunction. The interrelation between the neuropathy, cognitive dysfunction and gut is reviewed.

Methods: The exact mechanism is not understood but several hypotheses, cross-sectional studies and systematic reviews suggest a relationship between cognition and neuropathy. The review has collected data from various review and research publications that justifies this inter-relationship.

Results: The multifactorial etiology and pathophysiology of diabetic neuropathy is described with special emphasis on the role of gut dysbiosis. There might exist a correlation between the neuropathy and cognitive impairment caused simultaneously in diabetic patients.

Conclusions: This review summarizes the relationship that might exist between diabetic neuropathy, cognitive dysfunction and the impact of disturbed gut microbiome on its development and progression.

Keywords: Cognitive impairment; Diabetic neuropathy; Gut dysbiosis; Gut microbiome; Inflammation; Oxidative stress.

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Conflict of interest statement

Competing interestsThe authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Risk factors of Diabetic neuropathy. Diabetic neuropathy results from a series and simultaneous occurrences of certain factors. Most of the risk factors are modifiable and hence it becomes important for the patients and the healthcare professionals to pay attention to these factors in diabetic patients
Fig. 2
Fig. 2
Pathophysiology of Diabetic Neuropathy. The exact pathophysiology is not completely understood. The oxidative stress induced by constant hyperglycemic conditions pave way for inflammation which together causes nerve damage
Fig. 3
Fig. 3
Oxidative pathways. The four major pathways influencing the nerve damage are briefly explained in the above figure. All these pathways initiate because of an imbalance caused by abnormally high levels of glucose and result in the activation of various inflammatory and pro-inflammatory mediators
Fig. 4
Fig. 4
Healthy and damaged gut dysbiosis. The key difference between the two is the ability of the healthy gut to maintain integrity of the intestinal barrier. This integrity protects the system from getting affected by pathogenic substances and secondary metabolites produced by them
Fig. 5
Fig. 5
A brief overview on the interrelated conditions in diabetic patients. The exact mechanism is still being studied but various hypotheses suggest that these conditions might co-exist in patients
See this image and copyright information in PMC

References

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