Re: “Increased Langerhan cell density and corneal nerve damage in diabetic patients: Role of immune mechanisms in human diabetic neuropathy” by Tavakoli et al.

Diabetes mellitus is a global health problem of this era. Presently India is having the largest diabetic population of 50.8 million. In 2015, diabetes was the direct cause of 1.6 million deaths. Diabetes Mellitus is a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrates, fat and protein metabolism resulting from defects in insulin secretion. Diabetes, particularly type 2 is associated with various long-term complications like Diabetic retinopathy, nephropathy, neuropathy, etc., Globally diabetic neuropathy affects approximately 132 million people as of 2010 (1.9% of population). There is a higher prevalence (60.4%) and incidence (8.76%) of sensory peripheral neuropathy among the observed diabetic patients. In Ayurveda, the symptoms of Diabetic neuropathy are explained under the headings of Purvaroopa and upadrava of Prameha. Madhumeha is a bahudrava shleshma condition. So, Sarvanga Udvartana and Sarvanga Takradhara is been adopted to counteract the Samprapti of Prameha. A minimum of 20 subjects who fulfilled the diagnostic and inclusion criteria was subjected to the intervention. The overall results in the study revealed statistically highly significant result after the treatment on reducing symptoms and blood sugar levels.

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Role of phytotherapy in diabetic neuropathy and neurodegeneration: from pathogenesis to treatment

The Journal of Phytopharmacology ◽

10.31254/phyto.2018.7209 ◽

2018 ◽

Vol 7 (2) ◽

pp. 152-161

Author(s):

Nilay D Solanki ◽

◽

Shailesh K Bhavsar ◽

Dharmang T Pandya ◽

◽

...

Keyword(s):

Nervous System ◽

Diabetic Neuropathy ◽

Diabetic Complications ◽

Tissue Injury ◽

Retinal Disease ◽

The Body ◽

Diabetic Patients ◽

Chronic Hyperglycemia ◽

Organ Systems

Diabetes mellitus is a metabolic disorder associated with structural and functional alterations of various organ systems. The tissue injury is attributed primarily to chronic hyperglycemia. Diabetic complications are associated with microvascular and macrovascular damage to the major organs of the body, here in this topic role of herbals for complications of Nervous system in diabetes is discussed as a new therapeutic horizon. Peripheral neuropathy along with the small and large blood vessel disease can explain most of the diabetesrelated organ failure, over the last two decades that the deleterious effects of chronic hyperglycemia extend beyond neuropathy and angiopathy. Examples of such diabetic complications include opacification of the lens and central nervous system [CNS] dysfunction. In contrast to the high prevalence rate of renal failure in diabetic patients, except for retinal disease, the chronic diabetic complications of the CNS are subtle and often unrecognized. Whereas the CNS effects of acute alterations in blood glucose level are well known, the effect of chronic hyperglycemia on brain metabolism and cognitive function is not widely appreciated. All the conventional therapies for the diabetic neuropathy with neurodegeneration do have disadvantage from the point of view of efficacy and side effects. Since last few decades Herbals getting more attraction towards neuroprotection in CNS complications of diabetes, further more studies are going on herbals for neuroprotection in diabetes. In the treatment of diabetic neuropathy [DN] herbals and phytoconstituents were proved better option, because excellent efficacy and cost effectiveness compared to conventional treatment

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Corneal confocal microscopy differentiates inflammatory from diabetic neuropathy

Journal of Neuroinflammation ◽

10.1186/s12974-021-02130-1 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Michael Fleischer ◽

Inn Lee ◽

Friedrich Erdlenbruch ◽

Lena Hinrichs ◽

Ioannis N. Petropoulos ◽

...

Keyword(s):

Dendritic Cell ◽

Confocal Microscopy ◽

Diabetic Neuropathy ◽

Nerve Fiber ◽

Cell Density ◽

Chronic Inflammatory Demyelinating Polyneuropathy ◽

Basal Layer ◽

Nerve Fibers ◽

Corneal Confocal Microscopy ◽

Corneal Nerve

Abstract Background Immune-mediated neuropathies, such as chronic inflammatory demyelinating polyneuropathy (CIDP) are treatable neuropathies. Among individuals with diabetic neuropathy, it remains a challenge to identify those individuals who develop CIDP. Corneal confocal microscopy (CCM) has been shown to detect corneal nerve fiber loss and cellular infiltrates in the sub-basal layer of the cornea. The objective of the study was to determine whether CCM can distinguish diabetic neuropathy from CIDP and whether CCM can detect CIDP in persons with coexisting diabetes. Methods In this multicenter, case-control study, participants with CIDP (n = 55) with (n = 10) and without (n = 45) diabetes; participants with diabetes (n = 58) with (n = 28) and without (n = 30) diabetic neuropathy, and healthy controls (n = 58) underwent CCM. Corneal nerve fiber density (CNFD), corneal nerve fiber length (CNFL), corneal nerve branch density (CNBD), and dendritic and non-dendritic cell density, with or without nerve fiber contact were quantified. Results Dendritic cell density in proximity to corneal nerve fibers was significantly higher in participants with CIDP with and without diabetes compared to participants with diabetic neuropathy and controls. CNFD, CNFL, and CNBD were equally reduced in participants with CIDP, diabetic neuropathy, and CIDP with diabetes. Conclusions An increase in dendritic cell density identifies persons with CIDP. CCM may, therefore, be useful to differentiate inflammatory from non-inflammatory diabetic neuropathy.

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