PATHOPHYSIOLOGICAL FEATURES IN DIABETIC NEUROPATHY
Abstract:
Despite of the intense research of the last decades, there is no full understanding of the
pathogenetical factors, their dynamics and how they correlate with structural and functional
abnormalities seen in diabetic neuropathy (DN). DN results from damaging of neurons and axons by
hyperglycemia and from neuronal ischemia which results from decrease of neurovascular flow. The
vascular concept of DN involves the fact that endothelial dysfunction induced by diabetes with decrease
of the blood flow in nerve and endoneurial hypoxia plays a key role in structural and functional
abnormalities seen in diabethic nerve. Microangiopathy, or dysfunction of small blood vessels, is well
related to the complications of diabetes, such as nefropathy and retinopathy, but its exact role in
development of neural impairment is unknown. Defects in the vascular and metabolic ways interact with
oxidative stress and produce the start and the progression of neural injury which is seen in DN. These
ways include the formation of final products of advanced glycation, the alteration in ways of sorbitol,
hexosamina and protein kinase C, and activation of poli-ADP ribose polimerase
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