Diabetic neuropathy and nerve compression in diabetes

A more severe problem is the peripheral neuropathy, which is very common in the lower extremity and may affect up to 50% of the patients with diabetes. However, the extent of neuropathy in the upper extremity is less known. The pathophysiology of peripheral neuropathy in diabetes is complex and still obscure, but both metabolic and vascular factors are important. Interestingly, nerve compression, particularly the carpal tunnel syndrome, is more frequently seen in subjects with diabetes. The relation between neuropathy and concomitant nerve compression lesions is still not clarified. A new concept is based on the findings of a reduced number of nerve fibres in peripheral nerve trunks not only found in diabetes but also in healthy patients with carpal tunnel syndrome (found in non-compressed nerve). These observations indicate that there is a increased susceptibility to nerve compression not only in diabetes but also in some otherwise healthy subjects (Thomsen et al, 2009). In collaboration with Departments of Endocrinology (Ella Ekholm), Angiology (Anders Gottsäter and Karl-Fredrik Eriksson) and Neuropathology (Elisabeth Englund), we presently study complications to diabetes affecting the upper extremity – “the diabetic hand”. In those studies we also have a close collaboration with University of Manchester, UK, landspitali, Reykjavik, Island (Soley Thrainsdottir) and University of Umeå (Olov Rolandsson and Kaveh Pourhamidi).