Etiological Aspects for the Occurrence of Diabetic Neuropathy and the Suggested Measures
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Neurophysiology, Vol. 52, No. 2, March, 2020
Etiological Aspects for the Occurrence of Diabetic Neuropathy and the Suggested Measures M. Grover,1 R. Makkar,2 A. Sehgal,2 S. K. Seth,3 J. Gupta,1 and T. Behl2 Received July 6, 2019 Diabetic neuropathy is a painful devitalizing complication of diabetes affecting almost 20% individuals with this disease. Based on the area where neurons are mostly affected, it is categorized into four different types, proximal, peripheral, autonomic, and focal, and each type shows varying symptoms like numbness, gastric problems, heart problems, etc. Sometimes, these symptoms are mistakenly taken as those of gastric disorders, heart attack, or arrhythmia, with paying no attention to the inflamed neuronal supply in the particular area. Despite being aware of the symptoms, it is still a major challenging task for concerned endocrinologists and neurologists to diagnose it among the participants in clinics or in clinical trials. Treatment of diabetic neuropathy involves three major approaches, maintenance of the sugar level, pathogenetic treatment, and relieve of pain. Certain recommended drugs for pain relief are antidepressants (like duloxetine), GABA analogs (like gabapentin or pregabalin), and some other proposed treatments under research (like α-lipoic acid, aldose reductase inhibitors, or benfoitamine). The current drugs which are being provided for this disease are all indirectly acting and doesn’t have any direct action on the neuronal part. So, currently the need for today is to provide most potent drugs or combination of drugs to relieve the pain of diabetic neuropathy individuals by acting directly on the nerves without laying any side effects.
Keywords: diabetic neuropathy, bioenergetics, inflammation, myoinositol, polyol pathway.
INTRODUCTION Diabetic neuropathy (DN), or diabetic nerve damage, is a serious exaggerated complication of diabetes mellitus and is the foremost cause for the painful nerve damage. With time, numerous people are getting trapped inside this enormous network of diabetes mellitus, and, looking to this pace, WHO has regarded it as an “epidemic disease of the 21st century”. Non-curable diabetes starts damaging the neurons to less or more extent, which can lead to either painful or non-painful symptoms. However, it is always not necessary that this complication arises due to diabetes, but very often it can also give birth to diabetes [1]. But once occurred, it can drastically ruin the quality of life of the patient. Hence, this review article focuses on making the things clearly understood by exploring different
School of Pharmaceutical Sciences, MVN University, Palwal, Haryana, India. 2,3 Chitkara College of Pharmacy (2Department of Pharmacology, 3 Department of Pharmacy) Chitkara University, Rajpura, Punjab, India. Correspondence should be addressed to T. Behl (e-mail: [email protected]). 1
mechanisms involved in the pathogenesis of disease and also the related factors, ups and downs of which can contribute in the progression of disease. Also, it t
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