Excitable nerves mark symptomless diabetic neuropathy

The levels of diabetes are climbing worldwide, both Type 1 and Type 2, and this means that the numbers of people with diabetes-related complications are climbing, too. These include diabetic neuropathy, which affects around half of people with diabetes, and tends to be under-diagnosed. Knowing about neuropathy early on could help find people at risk and indicate a need for treatment and lifestyle changes. A team at the University of New South Wales in Australia believes that nerve excitability could be used as such a marker.

The nerve damage associated with diabetic neuropathy can affect a whole host of different parts of the body, from issues with digestion to problems with sex, and symptoms sometimes only emerge 10 to 20 years after the initial diagnosis of diabetes. However, the damage begins much earlier. The study, which was published in Diabetes, found that there were changes in excitability in the peripheral nerves before irreversible nerve damage had set in, and that these changes could be linked with HbA1c levels (a measure of blood sugar over the previous months).

"Excitability testing provides a biomarker to identify the early development and severity of diabetic neuropathy," according to author Cindy Lin.

These findings could lead to new therapeutic approaches for treating patients with diabetic neuropathy, preventing irreversible change. According to a commentary by Lin's colleague at the university, Matthew Kiernan: "It may yet prove possible to initiate therapy in diabetic patients well before they manifest the neurological symptoms and disability that inevitably reflects the presence [of] clinical neuropathy."

- read the press release
- see the abstract

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