Biochemical Derangements in Diabetes Mellitus
During the fifty-sixth year since the discovery of insulin, most physicians who are concerned with the care of the diabetic have become more willing to accept the possibility that the development of diabetic complications may be related to the metabolic consequences of hyperglycemia. Since those tissues which require insulin for the intracellular transport of glucose (i.e., muscle and fat) appear to be relatively immune to the ravages of diabetes, current research into the mechanisms by which an elevated glucose concentration could result in cellular damage has focused upon the so-called “noninsulin-dependent pathways of glucose metabolism.” Obviously, this term implies that, whereas these pathways are not directly activated by insulin, the hyperglycemia which results from insulin deficiency does foster their activation. It is the purpose of this review to consider certain of these pathways and the roles which they have been speculated to play in the development of diabetic complications.
KeywordsDiabetic Neuropathy Diabetic Animal Glomerular Basement Membrane Aldose Reductase Nerve Conduction Velocity
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