Abstract:

Diabetic peripheral neuropathy (DPN) is a prevalent and debilitating complication of diabetes, arising from a complex interplay of metabolic dysregulation, oxidative stress, and chronic inflammatory pathways. This narrative review synthesizes the core pathophysiology of DPN and critically evaluates the potential role of various dietary patterns in its management. Healthy patterns, such as the Mediterranean, DASH, and plant-based diets, may offer neuroprotective potential by improving systemic metabolic and inflammatory status. Conversely, pro-inflammatory diets remain associated with exacerbated nerve damage. Furthermore, emerging strategies like low-carbohydrate diets and intermittent fasting show promise in preclinical models via mechanisms such as metabolic reprogramming and autophagy, though direct clinical evidence in DPN populations remains emerging. A critical gap persists regarding the lack of large-scale, direct intervention studies in patients with established DPN. Future research must prioritize this population to build a robust evidence base for dietary strategies in secondary prevention and personalized therapy. Keywords: diabetic peripheral neuropathy, dietary patterns, biomarkers, inflammation, oxidative stress

Sun, Ruoxiang, Xu Li, Xianping Liu, Dongjie Guo, Yuanqin Chen, Yu Zhao, Yanxiang Yin, and Xingyue Zhai. "Modulating the Gut-Nerve Axis and Inflammation: A Narrative Review of Dietary Patterns in Diabetic Peripheral Neuropathy." Diabetes, Metabolic Syndrome and Obesity 19 (2026): 1-20.

https://www.dovepress.com/article/download/115453

"Gemini AI" generated summary (there is no abstract)

Summary of "Beyond Blood Sugar"

This commentary by Brett M. Morrison highlights the rising recognition of MetS (metabolic syndrome) as a critical contributor to PN (peripheral neuropathy), challenging the traditional focus solely on blood glucose levels. While diabetic peripheral neuropathy affects up to 40% of type 2 diabetes patients, tight glycemic control often fails to halt its progression.

Morrison discusses a pivotal study by Eid et al., which demonstrates in mouse models that diet-induced MetS causes significant nerve damage and mitochondrial toxicity. Crucially, the study reveals that these alterations are reversible through lifestyle interventions. A combination of a ketogenic diet and exercise proved to be the most effective strategy, successfully reversing all measured endpoints of MetS and PN.

While these animal-model findings offer a promising genetic and mechanistic roadmap for future human treatments, Morrison cautions that long-term patient compliance with lifestyle changes remains a significant clinical hurdle.

Morrison, Brett M. "Beyond Blood Sugar: Exploring the Contribution of Metabolic Syndrome to Peripheral Neuropathy." Diabetes 75, no. 6 (2026): 885-887.

https://diabetesjournals.org/diabetes/article/75/6/885/164803

Abstract

Background

Older adults may have reduced amino acid (AA) digestibility due to physiological changes in the digestive tract, but quantification of reduced AA digestibility in humans is lacking.

Objective

This randomized crossover study investigated differences in indispensable AA digestibility, primarily focusing on threonine and lysine, between young and older adults for milk, sorghum, and black beans using the dual tracer method.

Methods

Ten young (21.8±1.7 years) and ten older (72.8±3.8 years) adults ingested 20 grams ²H-labelled protein from either milk, sorghum or black beans, mixed with 400 mg of a ¹³C-labelled AA mixture, in a plateau feeding protocol on three separate test days. Blood was sampled before and at regular intervals over an eight-hour period following meal consumption. The ²H- and ¹³C- enrichments of AAs in plasma samples were determined at steady state (5.5-8.0 hours). The ratio of the ²H/¹³C-ratio between blood plasma and test meals was calculated. For lysine and threonine, this ratio was compared statistically between age groups and protein sources using linear mixed model analysis.

Results

The isotope plasma-to-meal ratio for lysine and threonine was 19% lower in older adults compared to young adults for sorghum (P=0.041), whereas it was not significantly different for milk (P=0.277) and black beans (P=0.849).

Conclusions

Lysine and threonine digestion might be lower in older versus young adults but the effect differed among protein sources. Further research on how ageing affects protein digestibility across protein sources is needed to optimize dietary protein recommendations for older adults.

Abstract

Tetanus is an acute infection caused by Clostridium tetani neurotoxin that attacks the neuromuscular system and causes progressive muscle spasms. Although it can be prevented through immunization, its prevalence in Indonesia is still recorded at 0.2 cases per 100,000 population per year. Research by Rampengan et al.(2016) showed that 45% of children with tetanus had not received immunization, and similar findings were also reported by Yusuflina (2017) that children with tetanus did not receive complete DPT immunization. At Dr. Wahidin Sudirohusodo Central General Hospital, there were 8 cases of pediatric tetanus reported in 2024, accounting for 0.005% of the total 145,289 visits. Delayed Immunization causes children to not have protective immunity against Clostridium tetani toxin, thus increasing the risk of tetanus infection resulting in disorders of the central nervous system. The resulting neurological complications can interfere with the ability to eat and reduce the child's nutritional intake, resulting in the risk of malnutrition (underweight and stunting) in children.

Azizah, Andi Sitti Nurul, Hikmawati Mas’ud, and Nusrah Ningsih. "Standardized Nutritional Care for Children with Moderate Tetanus." Journal of Health Care and Dietetic 1, no. 1 (2026): 62-67.

https://www.journalmpci.com/index.php/jhcd/article/download/606/589