Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy.
10.4093/dmj.2015.39.6.461
- Author:
Heung Yong JIN
1
;
Hong Sun BAEK
;
Tae Sun PARK
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea. pts@jbnu.ac.kr
- Publication Type:Review
- Keywords:
Autonomic neuropathy;
Autonomic pathways;
Diabetes;
Morphology
- MeSH:
Autonomic Nervous System;
Autonomic Pathways*;
Axons;
Diabetes Mellitus, Type 1;
Diabetes Mellitus, Type 2;
Diabetic Neuropathies*;
Humans;
Mortality;
Prevalence;
Skin;
Stomach
- From:Diabetes & Metabolism Journal
2015;39(6):461-467
- CountryRepublic of Korea
- Language:English
-
Abstract:
Diabetic neuropathy is one of the major complications of diabetes, and it increases morbidity and mortality in patients with both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Because the autonomic nervous system, for example, parasympathetic axons, has a diffuse and wide distribution, we do not know the morphological changes that occur in autonomic neural control and their exact mechanisms in diabetic patients with diabetic autonomic neuropathy (DAN). Although the prevalence of sympathetic and parasympathetic neuropathy is similar in T1DM versus T2DM patients, sympathetic nerve function correlates with parasympathetic neuropathy only in T1DM patients. The explanation for these discrepancies might be that parasympathetic nerve function was more severely affected among T2DM patients. As parasympathetic nerve damage seems to be more advanced than sympathetic nerve damage, it might be that parasympathetic neuropathy precedes sympathetic neuropathy in T2DM, which was Ewing's concept. This could be explained by the intrinsic morphologic difference. Therefore, the morphological changes in the sympathetic and parasympathetic nerves of involved organs in T1DM and T2DM patients who have DAN should be evaluated. In this review, evaluation methods for morphological changes in the epidermal nerves of skin, and the intrinsic nerves of the stomach will be discussed.
