Diabetic Central Neuropathy: CNS Damage Related to Hyperglycemia

The present narrative review presents emerging data regarding the association between diabetes mellitus and olfactory dysfunction and discusses the role of olfactory dysfunction in glucose metabolism. We searched relevant published articles in PubMed and Google Scholar until October 2021. Main key words included “olfactory dysfunction”, “diabetes mellitus”, and “glucose metabolism”. Olfactory dysfunction has been associated with diabetes mellitus. Furthermore, it has been proposed to be a diabetic complication, given that it has been linked with microvascular complications, such as diabetic peripheral neuropathy. Interestingly, it has been suggested that olfactory dysfunction is a manifestation of central neuropathy in diabetes, a hypothesis based on the observation that diabetes, olfactory dysfunction, and cognitive decline often coexist. However, evidence is limited and inconsistent. More importantly, olfactory and endocrine systems are closely linked, and olfactory dysfunction plays a significant role in glucose metabolism and obesity. Indeed, food behaviour and energy balance are influenced by olfaction status.

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Sexual dysfunction in the diabetic BB/WOR rat: a role of central neuropathy

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1997.272.1.r259 ◽

1997 ◽

Vol 272 (1) ◽

pp. R259-R267 ◽

Cited By ~ 6

Author(s):

K. T. McVary ◽

C. H. Rathnau ◽

K. E. McKenna

Keyword(s):

Sexual Function ◽

Diabetic Rats ◽

Nerve Fibers ◽

Diabetic Rat ◽

Penile Erections ◽

Reflex Testing ◽

Diabetic Impotence ◽

Central Neuropathy ◽

Sexual Reflexes

The pathophysiological mechanisms of diabetic impotence remain obscure. We have presented an analysis of sexual function in a diabetic rat (BB/WOR) model characterized by diffuse neuropathic changes without a confounding vasculopathy that allows us to define the neural components of erectile failure. Copulatory behavioral testing demonstrated that diabetic males were severely impaired: the controls mounted three times more than the diabetics and had about one-half the latency to first mount. The diabetics had about one-fourth the number of intromissions and took nearly twice as long to achieve first ejaculation. The number of ejaculations was drastically reduced as well. We examined sexual reflexes in the anesthetized acutely spinalized rat. These experiments tested the integrity of spinal circuits controlling sexual function. Reflex testing demonstrated that spinal sexual reflexes were also severely impaired: the onset latency of reflexes was more than doubled, and the duration of reflexes was less than one-half. More than one-half of the diabetic rats showed no penile erections. Neural studies showed even more derangement in reflex measures in rats, without erection. Nerve conduction velocity experiments suggested a peripheral neuropathic change in hypogastric nerve and motor pudendal nerve fibers. These dysfunctional findings were seen without any androgen deficiency. These results indicate that diabetic impotence in this model reflects central and peripheral neuropathic disease processes.

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The mechanisms of glycemic variability accelerate diabetic central neuropathy and diabetic peripheral neuropathy in diabetic rats

Biochemical and Biophysical Research Communications ◽

10.1016/j.bbrc.2018.12.179 ◽

2019 ◽

Vol 510 (1) ◽

pp. 35-41 ◽

Cited By ~ 6

Author(s):

Junpeng Yang ◽

Zhigang Zhao ◽

Huijuan Yuan ◽

Xiangxiang Ma ◽

Yakun Li ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Glycemic Variability ◽

Diabetic Rats ◽

Central Neuropathy

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γ-diketone central neuropathy: quantitative morphometric analysis of axons in rat spinal cord white matter regions and nerve roots

Toxicology and Applied Pharmacology ◽

10.1016/s0041-008x(03)00371-5 ◽

2003 ◽

Author(s):

R LoPachin

Keyword(s):

Spinal Cord ◽

White Matter ◽

Morphometric Analysis ◽

Rat Spinal Cord ◽

Nerve Roots ◽

Central Neuropathy

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Evaluation of central neuropathy in patients of chronic renal failure with normal hearing

Indian Journal of Otology ◽

10.4103/0971-7749.100716 ◽

2012 ◽

Vol 18 (2) ◽

pp. 76

Author(s):

Ravinder Sharma ◽

Sanjay Gaur ◽

Vivek Taneja ◽

Prachi Gautam ◽

Sanjay Kumar

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Normal Hearing ◽

Central Neuropathy

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Evaluation of central neuropathy in type 2 diabetes mellitus: a case control study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191012 ◽

2019 ◽

Vol 7 (4) ◽

pp. 1022

Author(s):

R. Balakrishnan ◽

K. Ramadoss ◽

E. Prasanna Venkatesan

Keyword(s):

Diabetes Mellitus ◽

Nervous System ◽

The Body ◽

Pattern Reversal ◽

P100 Latency ◽

System Involvement ◽

Non Invasive ◽

Central Neuropathy ◽

Visual Evoked

Background: Diabetes mellitus (DM) is a global pandemic affecting almost every organ in the body. Peripheral nervous system involvement in diabetes is well known but there are not many studies on central nervous system involvement. Visual evoked potential (VEP) is a sensitive, non-invasive test to detect central demyelination of optic nerve. The objective was to compare the visual evoked potentials in type-2 DM patients with that of healthy controls and to find out if any correlation is there with the duration and glycaemic control of the disease and to compare incidence of peripheral and central neuropathy in DM patients.Methods: Author included 50 DM patients and 50 age and sex matched controls. Patients with previous stroke, demyelination, diabetic retinopathy and other ophthalmological disorders were excluded. VEP was recorded using pattern reversal stimulation with EMG RMS MARK II machine and p100 latency was measured.Results: P100 latencies (ms) was significantly prolonged in diabetics with mean±SD of (111.24±5.28 ms) as compared to controls (101.30±1.66 ms) with p value <0.003. Also, there was significant correlation between duration of DM and P100 latency prolongation, but no significant correlation was present when compared with glycaemic control.Conclusions: Central neuropathy is very common in DM. It is related to duration of DM and not HbA1c unlike PNP which is related to both. Central neuropathy occurs even prior to development of retinopathy or PNP. Hence, VEP is a non-invasive and sensitive screening tool for early neurological involvement in DM.

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