Sural nerve pathology in diabetic patients with minimal but progressive neuropathy

R. A. Malik, S. Tesfaye, P. G. Newrick, D. Walker, S. M. Rajbhandari, I. Siddique, A. K. Sharma, A. J M Boulton, R. H M King, P. K. Thomas, J. D. Ward

    Research output: Contribution to journalArticlepeer-review


    Aims/hypothesis: The early pathological features of human diabetic neuropathy are not clearly defined. Therefore we quantified nerve fibre and microvascular pathology in sural nerve biopsies from diabetic patients with minimal neuropathy. Methods: Twelve diabetic patients underwent detailed assessment of neuropathy and fascicular sural nerve biopsy at baseline, with repeat assessment of neuropathy 8.7±0.6 years later. Results: At baseline, neuropathic symptoms, neurological deficits, quantitative sensory testing, cardiac autonomic function and peripheral nerve electrophysiology showed minimal abnormality, which deteriorated at follow-up. Myelinated fibre density, fibre and axonal area, and g-ratio were normal but teased fibre studies showed paranodal abnormalities (p
    Original languageEnglish
    Pages (from-to)578-585
    Number of pages7
    Issue number3
    Publication statusPublished - Mar 2005


    • Demyelination
    • Diabetes
    • Microangiopathy
    • Nerve fibres
    • Neuropathy
    • Schwann cell


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