Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

neuropathy with established nerve degeneration and capillary

occlusion cannot be ameliorated only by aldose reductase

inhibition, and further interventions with regenerative medi-

cine would be required.

Previous studies reported that introduction of NGF, HGF or

VEGF genes is a useful regenerative therapy of diabetic neuro-

pathy. We reported the usefulness of local injection of basic

FGF protein with cross-linked gelatin gel and transplantation

of various kinds of progenitor cells such as endothelial proge-

nitor cells (EPCs), mononuclear cells (MNCs), bone marrow-

derived mesenchymal stem cells (MSCs), and iPS cell-derived

neural crest cells (NCCs) on diabetic neuropathy with dia-

betic animal models. In addition, we have investigated the

possibilities of incretin-related agents to regenerate nerve

fibers.

In this session, an overview of current and future strategies for

treatment of diabetic neuropathy will be presented.

S21-3

Recent management of diabetic distal symmetric

polyneuropathy

Nigishi HOTTA

Japan Organization of Occupational Health and

Safety, Chubu Rosai Hospital, Nagoya, Japan

Diabetic peripheral neuropathy is a very common complica-

tion of diabetes often associated with considerable morbidity

and mortality. It appears relatively early in the disease

process. The most common manifestation is a distal symmet-

ric polyneuropathy, but many patterns of nerve impairment

can occur. Diabetic neuropathy is not a single entity, but

includes several neuropathic syndrome. Autonomic neur-

opathy may effect almost every system of our body, and once

it is well established in the patients with diabetes, it is very

difficult to treat for us.

The treatment of diabetic neuropathy is classified to symp-

tomatic- and causal-therapy. Current strategies for the treat-

ment of distal symmetric polyneuropathy are based on the

following:

①

reduction of risk factors including poor glycemic

control,

②

treatment based on pathogenetic mechanisms,

③

symptomatic treatment for such being neuropathic pain,

and

④

treatment of diabetic foot, autonomic and other compli-

cations. The previous three topics are talked over in my

presentation.

There are some differences of risk factors between type1

and type2 diabetes but mostly similar. Major factors are poor

glycemic control with age and duration of diabetes but

the development of diabetic neuropathy is also partly asso-

ciated with hypertension, hyperlipidemia, obesity and cigar-

ette smoking. Recently, there are the new appearance of useful

drugs for diabetic painful neuropathy such as pregabalin and

duloxetine. As the treatment based on pathogenetic mechan-

isms, many drugs have developed till today. However, unfor-

tunately, most of their clinical trials have failed to show its

efficacy. Only epalrestat, an aldose reductase inhibitor and

-lipoic acid, an anti-oxidant are available in clinical use at

limited countries.

We need for further experimental and clinical researches to

find more effective, novel compounds being able to slow,

prevent and/or reverse diabetic neuropathy.

Diabetic Eye Disease: Early Detection,

and Treatment

S25-1

Epidemiology of diabetic retinopathy, diabetic macular edema

and vision loss due to diabetes

Charumathi SABANAYAGAM

Far Eastern Memorial Hospital,

New Taipei, Taiwan

Diabetes is a major public health problem affecting 415 million

peopleworldwide in 2015 and the number is expected to rise to

642 million by 2040. In 2010, approximately a third of those

with diabetes were found to have signs of DR and of these, a

further one third were found to have vision-threatening

DR, including diabetic macular edema (DME). With the rising

prevalence of diabetes (in particular type 2), ageing of the

population and increased life expectancy, number of persons

with diabetic retinopathy (DR) is also expected to increase

substantially. In view of the increasing burden of diabetes and

DR, there has been significant global public attention and

research in recent years on understanding the epidemiology of

diabetes and DR, in an effort to develop long-term strategies

to manage this major public health problem. This talk will

highlight the recent trends in the epidemiology of DR with a

particular focus on the burden, awareness, population differ-

ences, risk factors, and screening of DR/DME.

S25-2

The pathogenesis and risk factors of diabetic retinopathy and

macular edema

Gavin TAN

Singapore Eye Research Institute, Singapore

The understanding of the pathogenesis of diabetic retinopathy

is constantly evolving with new research. The major risk

factors for diabetic retinopathy include duration of diabetes,

hyperglycemia, and hypertension, but these account for

only a small amount of the variation in the risk of diabetic

retinopathy. Studies have shown that factors such as dyslipi-

demia, ethnicity, genetics, nephropathy myopia and ocular

surgery contribute to the risk. Chronic exposure to hypergly-

cemia and other known risk factors results in a cascade of

biochemical and physiologic changes that ultimately lead to

microvascular damage and retinal dysfunction. Implicated

pathways include the accumulation of sorbitol and advanced

glycation end-products, oxidative stress, protein kinase C

activation, inflammation, and upregulation of the renin-

angiotensin system and vascular endothelial growth factor.

S25-3

Diabetic eye diseases

Chung-May YANG

National Taiwan University Hospital, Taipei,

Taiwan

The eye is one of the major organs affected by diabetic

mellitus. Structural and functional changes can be seen from

the cornea through the crystalline lens to the vitreo-retinal

tissues. Diabetic vitreoretinopathy is the most important

category related to diabetic eye diseases. The basic pathogen-

esis of diabetic vitreoretinopathy involves retinal vascular

permeability changes and vascular occlusion, which cause

macular edema and the development of retinal fibrovascular

proliferation through the excessive production of various

angiogenic factors. The progression of fibrovascular prolifer-

ation may induce vitreous hemorrhage, traction macular

elevation and traction retinal detachment, leading to severe

bilateral visual loss. In this presentation, clinical manifesta-

tions, update treatment strategies and outcome will be briefly

reviewed.

Diabetes Foot: Learning from Diabetes

Foot Care Program

S31-1

Diabetic foot problems and education programme on the

diabetic foot in Western Pacific Region

Shigeo KONO

National Hospital Organization, Kyoto Medical

Center, Kyoto, Japan

Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1

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