Diabetic neuropathy affects approximately 60-70% of people with diabetes. For such a common problem that affects patients with diabetes, little is known about peripheral neuropathy. Patients with diabetes who are suffering from peripheral neuropathy talk of how terrible it is to live with the condition: how a gentle touch can be agonizing and how a warm shower can be torturous. But, at the University of Virginia School of Medicine, new research has shed some more light on peripheral neuropathy's causes and may eventually suggest a way to reverse it.
"Normally pain is useful information because it alerts us that there is a damaging effect – something happening to tissues. But this pain is typically without any obvious reason," UVA researcher and anesthesiologist Dr. Slobodan M. Todorovic explains. "It's because nerves are being affected by high levels of glucose in the blood. So nerves start working on their own and start sending pain signals to the brain. It can be a debilitating condition that severely affects quality of life."
Dr. Slobodan Todorovic and Dr. Vesna Jevtoviv-Todorovic, Harold Carron Professor of Anethesiology and Neuroscience at UVA, have demonstrated the reversal of peripheral diabetic neuropathy in mice through the use of a substance that is naturally present in both humans and animals.
The researchers and their colleagues discovered that the high levels of blood sugar cause a change to the structure of channels that allow for the release of calcium into the nerve cells. This in effect forces them open and the overload of calcium into the cells causes them to become hyperactive. This high level of activity can lead to various effects, such as a slight tingling in the arms and legs or an excruciating pain.
Knowing this may prove to extremely important not only in the treatment of diabetic neuropathy, but in other conditions such as nerve injury from an accident, a wound received in combat or other causes for chronic pain. Dr. Todorovic stated that he and his research team found that the function of these calcium channels is similarly affected in these conditions.
The Todorovics said that finding more treatment options for diabetic neuropathy is very important because of the increasing prevalence of diabetes and the lack of therapeutic options. They go on to say that a commonly used drug was helpful for some but not all patients, often times causing considerable fatigue.
"A lot of patients decide to cope with the pain rather than to be sleepy all day," Todorovic said. However, the substance the University of Virginia researchers are testing in their study does not cause drowsiness. This is due to the fact that it works on the nerves rather than in the brain. "In some ways, you can think about it as going back to the baseline," Jevtovic-Todorovic said. "It's not a complete blockade; it’s a normalization."
The new findings have been published online by the journal Diabetes and will appear in a forthcoming print edition. The UVA researchers hope that reversing the early stages of diabetic neuropathy could prevent the complete loss of feeling associated with the advanced stages of the disease.
University of Virginia Press Release