Affiliation:
1. Chitkara College of Pharmacy, Chitkara University, Punjab, India
2. Department of Pharmacy, Southeast University, Dhaka, Bangladesh
3. Department of Biology, Faculty of Science, Selcuk Uniersity Campus, Konya, Turkey
Abstract
Diabetic neuropathy is referred to as a subsequential and debilitating complication belonging
to type 1 and type 2 diabetes mellitus. It is a heterogeneous group of disorders with a particularly
complex pathophysiology and also includes multiple forms, ranging from normal discomfort
to death. The evaluation of diabetic neuropathy is associated with hyperglycemic responses, resulting
in an alteration in various metabolic pathways, including protein kinase C pathway, polyol pathway
and hexosamine pathway in Schwann and glial cells of neurons. The essential source of neuronal
destruction is analogous to these respective metabolic pathways, thus identified as potential
therapeutic targets. These pathways regulating therapeutic medications may be used for diabetic
neuropathy, however, only target specific drugs could have partial therapeutic activity. Various antidiabetic
medications have been approved and marketed, which possess the therapeutic ability to
control hyperglycemia and ameliorate the prevalence of diabetic neuropathy. Among all antidiabetic
medications, incretin therapy, including Glucagon-like peptide-1 receptor agonists and dipeptidyl
peptidase-4 inhibitors, are the most favorable medications for the management of diabetes
mellitus and associated peripheral neuropathic complications. Besides enhancing glucose-evoked
insulin release from pancreatic β-cells, these therapeutic agents also play a vital role to facilitate
neurite outgrowth and nerve conduction velocity in dorsal root ganglion. Furthermore, incretin therapy
also activates cAMP and ERK signalling pathways, resulting in nerve regeneration and repairing.
These effects are evidently supported by a series of preclinical data and investigations associated
with these medications. However, the literature lacks adequate clinical trial outcomes related to
these novel antidiabetic medications. The manuscript emphasizes the pathogenesis, current pharmacological
approaches and vivid description of preclinical and clinical data for the effective management
of diabetic neuropathy.
Publisher
Bentham Science Publishers Ltd.
Subject
Cell Biology,Molecular Biology,Biochemistry,General Medicine
Cited by
8 articles.
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