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diabetic neuropathy

can someone please explain the neuropathology of diabetic neuropathy and relate it to its physiology? especially with the different tracts involved, why its bilateral and why it only affects the hand and feet! SO STUCK

Reply 1

nexttime

I have no idea about the precise pathophysiology and was under the impression it wasn't really known. I don't think it involves specific tracts, and the hands and feet are not the only parts involved, although the feet are the most common presumably because those nerves are the longest.

Reply 2

seaholme

http://www.ncbi.nlm.nih.gov/pubmed/18473845
^^ sums up the pathophysiology much better than what I half remember from pre-clin! I always just remember that it's to do with high blood glucose causing glycation of various body proteins, including the myelin around nerves which = bad. That article says it's macrophages which eat the glycated products so attack the nerves.

Don't think there's anything particularly to do with pathways and stuff about it. I imagine it's the peripheries which go first because they're the smallest nerves so get eaten away fastest, but this is just me guessing and somebody may come out and call me an idiot for it :P You also get a decent amount of autonomic disturbance in diabetes because it affects the autonomic nerves as well, and those are also tiny nerves so... additional evidence for my theory? :P

Reply 3

NeuropathyDoc

Surely. Diabetic Neuorpathy as a polyneuropathy affects more than one nerve most often bilaterally symmetric. DPN affects the longest axons first so feet are affected first. This is a peripheral not a central condition so there are no spinal cord tracts involved unless of course the patient has myelopathy.