"Dying back" axonal neuropathy

Diabetic neuropathy is a "dying back" axonal neuropathy. In a metabolically normal person, sensory neurons contain healthy mitochondria that traffic throughout the axon, providing the required energy for normal function. With diabetes, the mitochondria in sensory neurons undergo oxidative damage and become dysfunctional. These mitochondria are unable to provide the required energy to retain normal axonal function, leading to a distal to proximal "dying back" of the axons, and the corresponding signs and symptoms of diabetic neuropathy in the distal extremities.