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Painful diabetic peripheral neuropathy: Role of oxidative stress and central sensitisation

Ye, D.ORCID: 0000-0003-0668-2666, Fairchild, T.J.ORCID: 0000-0002-3975-2213, Vo, L.ORCID: 0000-0002-2714-5387 and Drummond, P.D.ORCID: 0000-0002-3711-8737 (2021) Painful diabetic peripheral neuropathy: Role of oxidative stress and central sensitisation. Diabetic Medicine, In Press . e14729.

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Diabetic peripheral neuropathy occurs in about half of people with diabetes, of whom a quarter may develop chronic pain. Pain may remain for years yet be difficult to treat because the underlying mechanisms remain unclear. There is consensus that processing excessive glucose leads to oxidative stress, interfering with normal metabolism. In this narrative review, we argue that oxidative stress may also contribute to pain.


We reviewed literature in PubMed published between January 2005 and August 2021.

Results and conclusions

In diabetes, hyperglycaemia and associated production of reactive species can directly increase pain signalling and activate sensory neurons; or the effects can be indirect, mediated by mitochondrial damage and enhanced inflammation. Furthermore, pain processing in the central nervous system is compromised in painful diabetic peripheral neuropathy. This is implicated in central sensitisation and dysfunctional pain modulation. However, central pain modulatory function is understudied in diabetes. Future research is required to clarify whether central sensitisation and/or disturbances in central pain modulation contribute to painful diabetic peripheral neuropathy. Positive results would facilitate early detection and future treatment.

Item Type: Journal Article
Murdoch Affiliation(s): Psychology, Counselling, Exercise Science and Chiropractic
Centre for Healthy Ageing
Publisher: Wiley
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