User:Morrey50/sandbox

Causes
The nerve damage was first thought to be caused my metabolic changes such as endoneurial microvessel disease, which is the degeneration of pericytes due to hyperglycemia, and the reproduction of basement membranes when the pericytes are no longer regulating their cell cycle. The decreased size of the lumen plus the absence of the pericyte, which regulate capillary blood flow and phagocytosis of cellular debris, leads to ischemia. Nerve biopsies have shifted the view toward an immune mechanism that causes microvasculitis, which could eventually lead to ischemia. Experimental treatments using immunosuppressing proteins have provided further corroborative evidence to the immune mechanism theory. Although this disease does occur in patients without diabetes the prevalence is much greater in the diabetic indicating that although hyperglycemia does not directly cause the nerve damage it may play a role