4.6 Review

Pathogenesis of Distal Symmetrical Polyneuropathy in Diabetes

Journal

LIFE-BASEL
Volume 12, Issue 7, Pages -

Publisher

MDPI
DOI: 10.3390/life12071074

Keywords

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

Funding

  1. Actegy Ltd.
  2. NIHR

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This article discusses the pathogenesis of DSPN, the successes and limitations of current therapies, and potential therapeutic targets. Recent research findings have called into question the definition of DSPN and transformed the disease model.
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.

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