Jarmila Vojtková, Peter Ďurdík, Lenka Dávidová, Miriam Čiljaková, Peter Bánovčin
Diabetic neuropathy (DN) is one of the chronic complications of diabetes mellitus. Etiopathogenesis of DN is multi-factorial. Several pathomechanisms are described – polyole pathway, non-enzymatic glycation of proteins, increased oxidative stress, decreased function of Na+K+-ATPase, low concentration of neural growth factor, increased activity of protein kinase C. Instead of long-lasting hyperglycemia genetic factors are important (gene polymorphisms for enzymes) as risk factors. It is for example aldose reductase, rate limiting enzyme of polyole pathway and enzymes of oxidative stress – glutathion-S-transferase, superoxid dismutase or uncoupling proteins. Cognition of gene polymorphisms enables therapy „made to measure“ in the future. As the prevention of oxidative stress antioxidants are used. In the clinical studies inhibitors of aldose reductase and C-peptide which stimulates Na+K+-ATPase activity are successfully used. Further studies are necessary for confirmation the efficacy of these drugs and for use in the clinical practice.