DIABETIC NEUROPATHY

ABOUT DIABETIC NEUROPATHY

Diabetic neuropathy is a chronic, progressive nerve‑damage that develops in people with diabetes. It most commonly affects the feet and legs causing symptoms ranging from numbness and tingling to severe neuropathic pain. 

It arises from prolonged hyperglycemia‑driven mitochondrial dysfunction and oxidative stress, ultimately leading to axonal degeneration and loss of nerve‑fiber integrity.

In the US, diabetic neuropathy affects half of diabetics, making it the most common chronic complication of the disease. Currently there are no approved disease‑modifying therapies that slow or reverse the underlying neuropathy itself. Existing treatments are limited to providing symptomatic relief. [1][2][3][4][5][6][7][8]

Key characteristics of diabetic neuropathy

Clinical presentation:

• Polyneuropathy with burning pain, tingling, numbness, and “pins‑and‑needles” sensations in the feet and lower legs, often associated with loss of protective sensation and increased risk of foot ulcers and amputation.[4][6][9]

Impact on patients:

• Chronic neuropathic pain, reduced mobility, impaired balance, and heightened fall risk significantly reduce quality of life and functional independence.[12][13][4]

• Sensory loss predisposes to undetected injuries and recurrent foot ulcers, contributing to high rates of hospitalization and lower‑limb amputation in severe cases.[6][9][4]

Mitochondrial dysfunction and oxidative stress:

• Sustained hyperglycemia increases mitochondrial reactive oxygen species production while impairing antioxidant defenses, leading damage to proteins, lipids, and DNA in peripheral nerves.[3][7][8]

• Mitochondrial fission‑fusion imbalance and bioenergetic failure disrupt axonal transport and energy‑dependent ion‑channel function, driving progressive axonal degeneration and neuropathy.[7][8]

Epidemiology and treatment gap:

• Studies estimate that 50–66% of people with diabetes mellitus will develop diabetic peripheral neuropathy during their lifetime, translating to tens of millions affected across the U.S. population.[2][9][4]

• Although FDA‑approved medications are available to manage neuropathic pain, there are no approved therapies that halt or reverse the structural nerve damage underlying diabetic neuropathy. [5][14][6]