Peripheral Neuropathy as a Component of Skeletal Disease in Diabetes

Current Osteoporosis Reports
Alec T BeeveErica L Scheller

Abstract

The goal of this review is to explore clinical associations between peripheral neuropathy and diabetic bone disease and to discuss how nerve dysfunction may contribute to dysregulation of bone metabolism, reduced bone quality, and fracture risk. Diabetic neuropathy can decrease peripheral sensation (sensory neuropathy), impair motor coordination (motor neuropathy), and increase postural hypotension (autonomic neuropathy). Together, this can impair overall balance and increase the risk for falls and fractures. In addition, the peripheral nervous system has the potential to regulate bone metabolism directly through the action of local neurotransmitters on bone cells and indirectly through neuroregulation of the skeletal vascular supply. This review critically evaluates existing evidence for diabetic peripheral neuropathy as a risk factor or direct actor on bone disease. In addition, we address therapeutic and experimental considerations to guide patient care and future research evaluating the emerging relationship between diabetic neuropathy and bone health.

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Citations

Nov 21, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Elif BörekciYalçın Aral
Mar 10, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Sumit PatelAmiethab Aiyer
Mar 27, 2021·Best Practice & Research. Clinical Endocrinology & Metabolism·Xiao ZhangErica L Scheller
May 4, 2021·Frontiers in Neuroscience·Alec T BeeveErica L Scheller
Sep 28, 2021·Acta Diabetologica·Joel Willem Johan LasschuitKatherine Thuy Trang Tonks

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Methods Mentioned

BETA
X-ray
electron microscopy
confocal microscopy

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