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Current Diabetes Reports

, 15:120 | Cite as

Exercise as Therapy for Diabetic and Prediabetic Neuropathy

  • J. Robinson SingletonEmail author
  • A. Gordon Smith
  • Robin L. Marcus
Microvascular Complications—Neuropathy (R Pop-Busui, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Microvascular Complications—Neuropathy

Abstract

Length-dependent neuropathy is the most common and costly complication of diabetes and frequently causes injury primarily to small-diameter cutaneous nociceptive fibers. Not only persistent hyperglycemia but also metabolic, endocrine, and inflammatory effects of obesity and dyslipidemia appear to play an important role in the development of diabetic neuropathy. Rational therapies aimed at direct control of glucose or its increased entry into the polyol pathway, oxidative or nitrosative stress, advanced glycation end product formation or signaling, microvascular ischemia, or adipocyte-derived toxicity have each failed in human trials of diabetic neuropathy. Aerobic exercise produces salutary effects in many of these pathogenic pathways simultaneously and, in both animal models and human trials, has been shown to improve symptoms of neuropathy and promote re-growth of cutaneous small-diameter fibers. Behavioral reduction in periods of seated, awake inactivity produces multimodal metabolic benefits similar to exercise, and the two strategies when combined may offer sustained benefit to peripheral nerve function.

Keywords

Diabetic neuropathy Exercise Metabolic syndrome Human trials Sedentary behavior Actigraphy 

Notes

Acknowledgments

All authors of this paper have funding from NIH that is supporting this work (NIH R01 DK064814).

Compliance with Ethics Guidelines

Conflict of Interest

J. Robinson Singleton, A. Gordon Smith, and Robin L. Marcus declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • J. Robinson Singleton
    • 1
    Email author
  • A. Gordon Smith
    • 1
  • Robin L. Marcus
    • 2
  1. 1.Department of NeurologyUniversity of UtahSalt Lake CityUSA
  2. 2.Department of Physical TherapyUniversity of UtahSalt Lake CityUSA

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