Has One Diabetic Complication Been Explained?

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Abstract
Recent developments suggest that the biochemical basis of diabetic polyneuropathy is now known, at least in broad outline. Polyneuropathy occurs in diverse hyperglycemic states that appear to have differing genetic and pathogenetic bases. The likelihood of clinical manifestations increases with the duration and severity of hyperglycemia,1 but the development of overt neuropathy is extremely variable, and it can be absent even after 40 years of poorly controlled juvenile diabetes. Since diabetic polyneuropathy has the pathological characteristics of a metabolic axonopathy,2 it appears that some metabolic factor common to diverse diabetic states governs the development of axonopathy but that the risk . . .