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Vascular Factors in Diabetic Peripheral Neuropathy: From Pathogenesis to Assessment and Management

Kumar Senthil P. , Kumar Senthil P. , Adhikari Prabha , Jeganathan P.S.

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Indian Journal of Biology 1(1):p 29-31, January - June 2014. | DOI:

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Abstract

This short communication was aimed at re-establishing the evidence for vascular changes and risk factors in pathogenesis, assessment and treatment of diabetic peripheral neuropathy (DPN), through a brief literature update from an evidence-informed perspective. Diabetes mellitus is known for its hyperglycemia and altered metabolic control leading to microvascular (neuropathy, nephropathy and retinopathy) and macrovascular (cerebrovascular disease, peripheral vascular disease and cardiovascular disease) complications which cause significant morbidity and mortality. Vascular risk factors such as higher levels of total and low-density lipoprotein cholesterol and triglycerides, a higher body-mass index, higher von Willebrand factor levels and urinary albumin excretion rate, hypertension, and smoking were associated with the incidence of neuropathy. Vascular assessment is now recommended as part of a comprehensive screening examination for diabetic neuropathic foot. Vascular dysfunction predisposed development of autonomic neuropathy in DPN. Treatment using vascular endothelial growth factor (VEGF), a potent growth factor for angiogenesis was also shown to facilitate nerve regeneration and subsequently Ropper et al studied intramuscular gene transfer using plasmid VEGF in their randomized clinical trial  Treatments such as transcutaneous frequency modulated neural stimulation produced release of VEGF.

Keywords: Vascular factors; Blood vessels; Arteries/veins; Hematology; Diabetic neuropathy.

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