Pathogenesis of diabetic neuropathy: the role of the n-6 essential fatty acids and their eicosanoid derivatives.

A substantial disturbance of the metabolism of the n-6 essential fatty acids exists in both human and experimental diabetes mellitus. Disturbances of the essential fatty acids and of the 1- and 2-series prostaglandins derived from them create a variety of microvascular, haemorheological, and other abnormalities leading to reduced blood flow and neural hypoxia which will in turn produce a cycle of hypoxia. Disturbance of the n-6 pathway may also result in functional and structural abnormalities of the axon, the myelin, and membrane-bound proteins such as enzymes and receptors. Metabolic disturbances identified previously may have a synergistic effect in enhancing these pathogenetic changes.