Cited by 1,697Pain Mechanisms and TreatmentsPeripheral Neuropathies and DisordersAldose Reductase and Taurine

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Diabetic neuropathy

Feldman, Eva L., Callaghan, Brian C., Pop-Busui, Rodica, Zochodne, Douglas W., Wright, Douglas E., Bennett, David L., Bril, Vera, Russell, James W., Viswanathan, Vijay·2019·Nature Reviews Disease Primers

DOI 10.1038/s41572-019-0092-1

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Abstract

The global epidemic of prediabetes and diabetes has led to a corresponding epidemic of complications of these disorders. The most prevalent complication is neuropathy, of which distal symmetric polyneuropathy (for the purpose of this Primer, referred to as diabetic neuropathy) is very common. Diabetic neuropathy is a loss of sensory function beginning distally in the lower extremities that is also characterized by pain and substantial morbidity. Over time, at least 50% of individuals with diabetes develop diabetic neuropathy. Glucose control effectively halts the progression of diabetic neuropathy in patients with type 1 diabetes mellitus, but the effects are more modest in those with type 2 diabetes mellitus. These findings have led to new efforts to understand the aetiology of diabetic neuropathy, along with new 2017 recommendations on approaches to prevent and treat this disorder that are specific for each type of diabetes. In parallel, new guidelines for the treatment of painful diabetic neuropathy using distinct classes of drugs, with an emphasis on avoiding opioid use, have been issued. Although our understanding of the complexities of diabetic neuropathy has substantially evolved over the past decade, the distinct mechanisms underlying neuropathy in type 1 and type 2 diabetes remains unknown. Future discoveries on disease pathogenesis will be crucial to successfully address all aspects of diabetic neuropathy, from prevention to treatment.

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Authors: Feldman, E. L., Callaghan, B. C., Pop-Busui, R., Zochodne, D. W., Wright, D. E., Bennett, D. L., Bril, V., Russell, J. W., & Viswanathan, V.
Affiliations: University of Michigan (US)
University of Alberta (CA)
University of Kansas Medical Center (US)
University of Oxford (GB)
University Health Network (CA)
VA Maryland Health Care System (US)
M.V. Hospital for Diabetes and Diabetes Research Centre (IN)
Corresponding author: Feldman, Eva L.
ORCID: Feldman, Eva L.
Callaghan, Brian C.
Zochodne, Douglas W.
Wright, Douglas E.
Bennett, David L.
Bril, Vera
Russell, James W.
Viswanathan, Vijay
Venue: Nature Reviews Disease Primers
Publisher: Springer Science and Business Media LLC
Published: 2019-06-13
Volume: 5
Issue: 1
Pages: 41-41
ISSN: 2056-676X (ISSN-L)
DOI: 10.1038/s41572-019-0092-1
OpenAlex: W4211145818
Cited by: 1,697
References: 225
Citations by year: 2026: 246 · 2025: 337 · 2024: 364 · 2023: 272 · 2022: 220 · 2021: 149 · 2020: 78 · 2019: 13
FWCI: 13.51
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Nature Reviews Disease Primers (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs (101RX001030)
Diabetes Action Research and Education Foundation
Wellcome Trust (102645, 102645/Z/13/Z, 202747/Z/16/Z, 202747/Z/16/)
Diabetes Canada
European Commission (HORIZON2020)
Novo Nordisk Fonden (NNF14OC0011633)
National Institutes of Health (R01D107956)
Clinical Science Research and Development
Geriatric Research Education and Clinical Center
Canadian Institutes of Health Research
National Institute of Diabetes and Digestive and Kidney Diseases (R24DK082841, R01DK115687, R01DK107007)
National Institute of Neurological Disorders and Stroke (K23NS079417)
NIH Clinical Center
Topics: Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Clinical Neurology › Peripheral Neuropathies and Disorders
Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Aldose Reductase and Taurine
Keywords: diabetic neuropathy, distal symmetric polyneuropathy, type 1 diabetes, type 2 diabetes, glycemic control, prediabetes, neuropathic pain, neuropathy prevention, neuropathy treatment, opioid avoidance, pathogenesis
MeSH terms: Serotonin and Noradrenaline Reuptake Inhibitors, Analgesics, Opioid, Diabetic Neuropathies, Humans, Hyperglycemia, Hyperlipidemias, Mass Screening, Quality of Life, Risk Factors, Prevalence, Pain Management

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