Diabetic polyneuropathy: achievements in understanding the problem

E.V. Biryukova, E.S. Gannenkova, I.V. Solovieva

A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow

Diabetes mellitus (DM) is one of the common causes of polyneuropathy, which reduces the ability to work, affects life quality, and can lead to disability. Disease duration and the lack of targeted glycemia control are the leading risk factors causing damage to the nervous system. The most common and well-known form of diabetic polyneuropathy is distal neuropathy. The development of this DM complication is based on a complex of interrelated pathological mechanisms. The damaging effect of hyperglycemia comes through a cascade of glucose metabolism pathological pathways. In recent years, there has been growing interest in the problem of vitamin B₁₂ deficiency (cyanocobalamin) in polyneuropathies of various origins, since this vitamin plays an important role in the functioning of the nervous system. Among the neurotropic effects of vitamin B₁₂, the most significant are the abilities to restore the myelin sheath structure, accelerate nerve regeneration and reduce neuropathic pain. Data review on the problem of vitamin B₁₂ deficiency, which may be associated with the use of certain medications, is presented. Commonly, the development of cobalamin deficiency is observed in patients with type 2 DM receiving metformin for more than 5–10 years. The authors consider the possibilities of pathogenetic therapy in diabetic neuropathy associated with the use of Neuromultivit.

Keywords: diabetes mellitus, polyneuropathy, hyperglycemia, B₁₂ deficiency, B vitamins, transketolase, Neuromultivit.

For citation: Biryukova E.V., Gannenkova E.S., Solovieva I.V. Diabetic polyneuropathy: achievements in understanding the problem. RMJ. 2020;1:14–19.