Cry in a test tube
Analysis of tears will help predict complications in type I diabetes mellitus
Lacrimal fluid can warn of the onset of diabetic peripheral neuropathy. An article about this was published in The Ocular Surface (Tummanapalli et al., Tear film substance P: A potential biomarker for diabetic peripheral neuropathy).
Diabetic neuropathy is one of the most common complications of diabetes. This is a disorder of the nervous system, which is caused by damage to small blood vessels due to the disease. It leads to a decrease in the ability to work of patients, and in some cases – to death.
Neuropathy occurs in almost 50% of diabetics. Symptoms of neuropathy are pain, numbness and tingling of the limbs, loss of balance, weakness and ulcers on the legs. Although nerve damage cannot be reversed, early diagnosis of neuropathy can help patients better prepare and prevent further complications. However, the existing options for early diagnosis are limited to invasive studies – for example, skin biopsy.
Scientists from the University of New South Wales have shown that the earliest signs of peripheral diabetic neuropathy can be found in the tears of a patient. "In people with type I diabetic peripheral neuropathy, which can lead to recurrent leg ulcers and in severe cases requires amputation, the levels of the so–called substance P are reduced in tears," says Maria Marculli, one of the authors of the study. – Peripheral neuropathy in the early stages is very difficult to detect, and it requires special training. We offer a fast, non-invasive diagnostic method that even a layman can carry out."
Substance P is a neuropeptide (a protein formed in the nervous system). It has a wide range of biological effects: dilates blood vessels, increases capillary permeability, causes smooth muscle contractions, and also takes an important part in the transmission of pain impulses to the central nervous system.
In their work, the researchers tested the concentration of two neuropeptides in the lacrimal fluid of people with type I and type II diabetes, comparing them with similar indicators in healthy people from the control group. Although the researchers found that patients with type I diabetic peripheral neuropathy had less substance P in the lacrimal fluid, the results do not suggest the presence of the same biomarkers for type II diabetes. "Perhaps this is due to the fact that such diseases have various pathologies and risk factors," the authors explain.
The results of the studies are very encouraging for patients with type I diabetes. Scientists want to conduct further research to make tear analysis commercially available. In particular, the researchers hope to study the loss of substance P over time depending on the severity of peripheral neuropathy. In addition, they want to expand the field of studying neuropathies and determine whether there are diagnostic markers of this complication in the lacrimal fluid and for type II diabetes.
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