2018 年 35 巻 3 号 p. 284-287
Diabetic neuropathy is a common peripheral neuropathy. Glycemic control is most essential to prevent the development of diabetic neuropathy. The presence of hypertension, obesity, smoking and hyperlipidemia may exacerbate diabetic neuropathy. Thus in order to suppress the progression of diabetic neuropathy, it is necessary to strictly control these factors.
Epalerstat, an aldose reductase inhibitor, is only one commercially available drug for the treatment of diabetic neuropathy. However, epalerstat is ineffective cases of severe neuropathy and patients with poor glycemic control. Future availability of new drugs is expected, but development has not been successful thus far.
In the development of new drugs, it is important to detect early abnormalities in diabetic neuropathy. The loss of small fiber in the epidermis is an early pathological change in diabetic neuropathy and this change, as well as skin denervation can be detected by skin biopsy. However, special skills are required for specimen analysis, and only a few laboratories in Japan can analyze skin biopsy specimen. Therefore, the establishment of an easy and efficient method to evaluate abnormalities in the early phases of diabetic neuropathy is very important.
