Dr. Feldman authors review aimed at shifting worldwide diabetes research

March 22, 2017

Ann Arbor, Michigan – Breakthroughs in understanding the role of fats in the blood, energy transfer between cells, and whole-system analysis are providing clearer paths for researchers seeking therapies for diabetic neuropathy, according to a review written in part by Program for Neurology Research & Discovery (PNR&D) Director Eva L. Feldman, MD, PhD, and published today in the medical journal Neuron.

The review, which explores emerging insights into diabetic neuropathy, the nerve damage that is linked to diabetes, is a departure from earlier research that focused on blood sugars in understanding diabetic neuropathy. By turning their attention elsewhere, researchers are identifying potentially more effective targets for drugs to combat diabetic neuropathy, the leading cause of diabetes-related amputations.

The review was a multinational effort that included senior investigators Klaus-Armin Nave of the Max Planck Institute for Experimental Medicine in Gottingen, Germany; Troels S. Jensen of Aarhus University in Denmark; and David L.H. Bennett of the University of Oxford in the United Kingdom.

“By combining with key leaders in these various aspects of diabetic neuropathy research, we’ve highlighted recent game-changing advances that have redirected our approach to solving this common but vexing problem,” Dr. Feldman said. “By outlining these discoveries, we hope to reset the focus of diabetic neuropathy research and direct investigators toward new therapeutic targets. I’ve spent my entire career studying diabetic neuropathy. This is a very exciting time for the field.”

Recent technological advances have facilitated research that is examining entire human systems rather than isolated processes within the body. Using genome-wide profiling, investigators can look at entire systems to better understand how genes interact and activate body functions.

Additionally, recent research suggests that nerve damage from diabetes may result from alterations in the relationship between nerves and Schwann cells, the cells which normally protect and support neurons in the peripheral nervous system. Research under way at the University of Michigan has connected the effectiveness of this relationship with the level of lipids, or fats, in the bloodstream.

Because of these discoveries, future treatments for diabetic neuropathy may include targeting these emerging disease mechanisms with pharmaceuticals, in addition to more personalized treatment for each patient, the researchers said.

According to the Centers for Disease Control, more than 29 million Americans are living with diabetes and another 86 million are pre-diabetic, a condition that increases a person’s risk of Type 2 diabetes and other chronic diseases. Diabetes is caused by either an inability to generate insulin (Type 1) or an inability to use insulin properly (Type 2). Insulin allows sugars to be used by cells as energy; without effective insulin, sugars build up in the blood and can cause heart disease, stroke, blindness, kidney failure, and nerve damage which leads to amputation of toes, feet or legs.