Scientific background

Type 1 diabetes

The world is currently seeing an epidemic of diabetes, affecting 60 million Europeans and 26 million Americans, and the incidence is increasing by 5% every year. In Denmark, 30,000 new cases of diabetes are diagnosed each year, and more than 320,000 people (~ 6% of the population) are currently living with diabetes. The most common complication of diabetes is distal symmetric polyneuropathy, which is defined as a symmetrical, length-dependent sensorimotor polyneuropathy attributable to metabolic and microvascular alterations as a result of chronic hyperglycaemia exposure and cardiovascular risk covariates.

The prevalence of diabetic neuropathy ranges from 30 to 50%, and up to 25% of individuals with pre-diabetes also develop diabetic neuropathy. Diabetic neuropathy is characterised by progressive loss of peripheral nerve axons, resulting in decreased sensation, pain, and, in the end, complete loss of sensation. It is the leading cause of diabetes-related hospital admissions and non-traumatic amputations in both Europe and the USA and incurs significant worldwide economic costs. There are currently no obvious disease-modifying treatments available for diabetic neuropathy other than glycaemic control and symptomatic treatment of pain. Indeed, pain is a major problem in diabetic neuropathy, but current treatment is insufficient, with less than two-thirds of patients obtaining sufficient pain relief. It is clear that there is a critical need to identify novel effective therapies for diabetic neuropathy.

The development of targeted therapies for diabetic neuropathy has been hindered by our lack of understanding of the complex and different aetiologies of diabetic neuropathy. Clinical studies confirm that there are different mechanisms underlying diabetic neuropathy in type 1 and type 2 diabetes, including microvascular insufficiency, oxidative stress, dyslipidemia, insulin resistance inflammation, and mitochondrial dysfunction. Nevertheless, there are no available treatments for diabetic neuropathy other than glucose control. Diabetic neuropathy represents a severe, disabling – and until recently – largely neglected problem. There is therefore an urgent need to address this worldwide problem and to carry out a multinational interdisciplinary project on fundamental aspects related to diabetic neuropathy. The IDNC is prepared to take up this challenge in the years to come.