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Brain research highlights effects of diabetic neuropathy

JDRF researchers at the University of Sheffield have shed new light on the effect that diabetic neuropathy has on the brain.

The work could lead to better ways of monitoring, and subsequently treating, the condition in future.

Diabetic neuropathy is a condition that damages the nervous system – the network that carries messages between the brain and all parts of the body. It affects around a third of people with type 1 and type 2 diabetes, and occurs when long-term high blood glucose levels damage the blood vessels that supply the nerves.

Previous studies have suggested that this damage is mostly confined to the areas outside the brain, with any damage to the brain being limited. For researchers hoping to find treatments for the condition, this suggestion has focused attention on nerves in the rest of the body.

However, the Sheffield team found that MRI scans of the brain can detect changes caused by diabetic neuropathy. The condition seems to reduce the volume of the brain’s grey matter, which is involved in processing touch and pain sensory information.

The finding means that doctors treating the condition have another avenue to explore when searching for treatments, and a new way to monitor the progress of the condition. It also complements JDRF-funded research into improving people’s glucose management – such as the artificial pancreas project – as this can help reduce the risk of diabetic neuropathy in the first place.

Dr Dinesh Selvarajah, Senior Lecturer and Honorary Consultant in Diabetes at the Royal Hallamshire Hospital, Sheffield, who led the research, said: ‘Diabetic nerve damage has a massive impact on the quality of people’s lives, physically, mentally and socially.

‘Our study reveals for the first time how extensively involved diabetic neuropathy is in the brain, causing shrinking and a reduction in the main part of the brain associated with sensation.

‘The next steps will be for us to investigate at what stage [this change] occurs, what the consequences of this are and whether it can be prevented as it could be impacting on patients’ behaviour and psychology.’

Karen Addington, Chief Executive of JDRF, said: ‘This excellent research highlights new ways of monitoring the effects of diabetic neuropathy, which will hopefully lead to the development of new and innovative ways of treating this life-changing complication.’

The research was published in the journal Diabetes Care.


Why do some people with type 1 never have complications?

Everyone knows we should value the knowledge and experience of the older generation. Now JDRF-funded researchers are acting on this advice, and turning to people who have had type 1 diabetes for more than 50 years to gain new insights into how the condition progresses.

The results of this study, led by researchers at the Joslin Diabetes Center in the USA, have been published in the journal Diabetes Care. By looking at people who have spent fifty or more years living with type 1, the team aimed to shed light on factors that provide a protective effect against the complications of type 1.

Using medical records, the 351 participants were assessed for retinopathy, nephropathy, neuropathy and cardiovascular disease in relation to diabetes measures like HbA1c levels. A high proportion of the group were shown to be completely free from these complications, independent of their blood glucose control over the previous 15 years. This suggests they have inbuilt protection mechanisms that could be useful targets for therapies to benefit the general population.

Lead researcher, Professor George King, said: ‘If we can identify what constitutes this protective mechanism, we have the potential to induce such protections in others living with diabetes. That's huge.’

Read the full article here