Stem Cell Therapy For Neuropathy | The Condition
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The Condition

Diabetic Neuropathy FAQs

 

A major complication of diabetes is damage to the peripheral nerves. The number of patients with diabetic neuropathy worldwide is increasing in prevalence. Diabetes affects the eyes, heart, kidneys, and nervous system.

Which nerves are affected by diabetic neuropathy?

Diabetes affects both the sensory (feeling) and motor (doing) nerves, including the cranial nerves thoracic nerves, and autonomic nerves. When diabetes damages just one nerve it is known as diabetic mononeuropathy. However, when it affects multiple nerves of the distal limbs, it is called diabetic polyneuropathy.

How common is diabetic neuropathy?

In the United States, around 65% of diabetics have some type of nerve damage, according to the National Diabetes Statistics fact sheet. Around 3% of newly diagnosed diabetes patients already have existing neuropathy. Patients at the greatest risk of developing neuropathy are those who have poorly controlled glucose levels.

What are the symptoms of diabetic neuropathy?

The symptoms of diabetic neuropathy are specific to the exact type of disease. With polyneuropathy, patients have tingling and other unpleasant sensations (called paresthesias), as well as numbness of the feet and hands. Weakness of the muscles is also common. With mononeuropathy, patients have symptoms specific to the area, such as nausea and vomiting with autonomic neuropathy and sensory deficit of the face with cranial neuropathy.

What causes diabetic neuropathy?

Prolonged exposure to high glucose levels in the bloodstream damages delicate nerve fibers over time. Experts believe this occurs from a complex interaction between blood vessels and nerves. The high blood sugar interferes with the nerves’ ability to transmit signals, and also weakens the walls of capillaries (small blood vessels) that supply nerves with nutrients and oxygen. Other factors that contribute to the development of diabetic neuropathy include inflammation in the nerves, genetic factors, smoking, and alcohol abuse.

How is diabetic neuropathy diagnosed?

The diagnosis of diabetic neuropathy is based on history, clinical examination, and supporting laboratory investigations. The doctor will conduct some nerve conduction studies, and possibly conduct ultrasounds.

How is diabetic neuropathy diagnosed?

The treatment of diabetic neuropathy focuses on control of glucose levels, weight loss, and exercise to reduce insulin resistance. Neuropathic pain related to neuropathy is often treated with anticonvulsants, which are useful for nerve-related pain. Other drugs prescribed include antidepressants and opiate drugs.

Does stem cell therapy treat diabetic neuropathy?

Many clinical studies support the use of stem cell therapy for treatment of diabetic neuropathy. Because diabetic neuropathy involves reduction of vascularity in the peripheral nerves and deficiency in angiogenic and neurotrophic factors, stem cell therapy is showing great promise for nerve cell regeneration. The stem cells are effective in the repair of vascular structures that deliver blood to the nerves. In a study where bone-marrow derived stem cells were used to treat peripheral nerve damage, researchers found that the stem cells worked through direct modulation of nerves. In the study, the stem cells helped increase proliferation of endothelial cells as well.


 

Peripheral Neuropathy FAQs

 

Peripheral neuropathy is the result of damage to the complex structure of peripheral nerves that supply the arms, hands, legs, and feet. Neuropathy means nerve damage. This condition can lead to serious prolonged and chronic pain. Peripheral neuropathy affects the ability of these nerves to properly send and receive signals to and from the brain.

 

How common is peripheral neuropathy?

In the United States, around 20 million people have some type of peripheral neuropathy. This condition is often associated with diabetes mellitus.

What are the symptoms of peripheral neuropathy?

The symptoms of peripheral neuropathy include prickling sensations (paresthesias), muscle weakness, numbness, and tingling. Areas of the body also have exaggerated response to touch (allodynia). Symptoms also include burning pain (worse a night), sweating, and muscle wasting.

Is there more than one type of peripheral neuropathy?

There have been more than 100 types of peripheral neuropathy identified, and each has its own prognosis, symptoms, and causes. When only one nerve is affected, it is called mononeuropathy, and when multiple nerves are affected it is called polyneuropathy. Some neuropathies are caused by damage to the axons, which are threadlike, long portions of nerve cells. Other types are caused by damage to the myelin sheath, which is the fatty protein that insulates and covers the axon.

What is the difference between motor nerve damage and sensory nerve damage?

Motor nerve damage is associated with muscle weakness, and symptoms include muscle twitching, cramps, and decreased reflexes. Sensory nerve damage is associated with loss of reflexes, impaired sensation, and balance problems. Damage to sensory fibers will interfere with the ability to sense temperature changes or feel an injury to the hand/foot.

What causes peripheral neuropathy?

Peripheral neuropathy is acquired through disease, due to trauma, or inherited. Repetitive stress can lead to entrapment neuropathies, which is a type of compression injury. Injury from a fall, automobile accident, or surgery can cause nerves to be partially or completely severed, compressed, stretched, or crushed. Metabolic and endocrine disorders, autoimmune disease, small vessel diseases, kidney disorders, infections, and neuromas all can lead to peripheral neuropathy.

How is peripheral neuropathy diagnosed?

If your doctor suspects peripheral neuropathy, he will take an extensive medical history and conduct a physical examination. Blood tests are used to assess liver and kidney function, metabolic disorders, and genetic abnormalities. These studies include nerve conduction velocity (NCV) to measure the degree of damage to nerve fibers, electromyography to assess electrical activity of muscles, nerve biopsies, and magnetic resonance imaging.

How is peripheral neuropathy managed?

Unfortunately, since this condition is chronic, doctors usually aim to control symptoms and pain. Anti-inflammatory drugs are used for pain, and anticonvulsants work to control certain brain chemicals and pain. In addition, tricyclic antidepressants (amitriptyline and nortriptyline) are used for pain control, as they work to alter pain signals in the brain. Another effective pain management tactic is transcutaneous electrical nerve stimulation (TENS), which is proven useful for neuropathic (nerve-related) pain.

Does stem cell therapy help with chronic peripheral neuropathy?

Researchers of Duke University have found that stem cell therapy (now being treated on animals) has suburb potential to provide long-lasting pain relief for peripheral neuropathy. According to the study, bone marrow-derived stem cell therapy helped with pain relief after only a single injection. The molecule emitted from the damaged nerve cells acts as a homing signals to attract stem cells, according to the researchers’ theory. In another study, diabetic rats given stem cells experienced new blood vessel growth and remarkable restoring of the nerve’s myelin sheath (protective covering).

Resources

National Institute of Neurological Disorders (2017). Peripheral Neuropathy Fact Sheet. Retrieved from: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet

Daudon M & Jungers P (2007). Diabetes and nephrolithiasis. Curr Diab Rep, (6):443-8.

Han JW,Si MY, & Yoon YS (2013). Cell Therapy for Diabetic Neuropathy Using Adult Stem or Progenitor Cells. Diab Metab J, 37(2) 91-105.

Jeong JO, Kim MO, Kim H, et al. (2009). Dual angiogenic and neurotrophic effects of bone marrow-derived endothelial progenitor cells on diabetic neuropathy. Circulation, 119:699–708


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