Posted on February 14, 2015

Weill Cornell Medical College in Qatar (WCMC-Q) researcher Dr. Rayaz Malik has co-edited the prestigious medical textbook Handbook of Clinical Neurology, which will serve as a comprehensive guide for clinicians and researchers dealing with complications of the nervous system arising from diabetes. Dr. Malik, Professor of Medicine at WCMC-Q, jointly edited the 640-page textbook, the full title of which is Diabetes and the Nervous System: Handbook of Clinical Neurology, with Dr. Douglas Zochodne, Professor of Neurology at the University of Alberta.

The handbook, which took three years to compile, is comprised of 36 chapters written by the world’s foremost experts in the field of diabetic neuropathy from elite institutions in North America, Europe, New Zealand, Japan and here in Qatar. The handbook provides a comprehensive update on experimental and translational studies of the peripheral and central nervous system in children and adults with diabetes and pre-diabetes. The latest diagnostic techniques including peripheral and central imaging as well as therapies for diabetic neuropathy are discussed in detail. 

Diabetic neuropathy is characterized by nerve damage and is the most common complication of diabetes. It is also more common than multiple sclerosis, Parkinson's disease, and amyotrophic lateral sclerosis combined and is a major source of disability in diabetic persons worldwide. Diabetic neuropathy causes a diverse range of symptoms and signs including loss of sensation and pain in the extremities, digestive and urinary as well as cardiac and cerebral problems. Loss of sensation in the extremities predisposes sufferers to foot ulcers and infections, which can result in lower limb amputation.

Dr. Malik said: “The global diabetes and obesity epidemic means that diabetic neuropathy, which affects at least 50 percent of all diabetic patients, has become an extremely pressing health issue for both medical science and society at large. “Our aim with the handbook is to provide a comprehensive and up-to-date guide for clinicians and researchers to help bridge the translational gap towards earlier diagnosis and treatment with the best therapies to improve patient outcomes.”

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Dr. Malik pioneered the development of a novel diagnostic exam for diabetic neuropathy, which involves live imaging of the patient’s cornea through a special microscope. The exam allows physicians to diagnose nerve damage and repair earlier than previous ‘gold standard’ diagnostic tests such as skin biopsy or electrophysiology. It also represents a unique surrogate endpoint for assessing the efficacy of new drug therapies for diabetic neuropathy.

Dr. Malik explained: “While researchers have been able to demonstrate the viability of many experimental therapies in the laboratory, all have fallen by the wayside as there is currently no FDA-approved therapy for human diabetic neuropathy. This highlights the translational gap, which may well be due to a lack of an ability to demonstrate therapeutic efficacy in humans, rather than a true lack of efficacy. “Overall the handbook shows that there is a lot of research going on in the field of diabetic neuropathy, but also highlights the roadblocks and difficulties that researchers have encountered. This knowledge will hopefully be a useful guide to researchers working towards the development of an effective new therapy for diabetic neuropathy.”

Dr. Khaled Machaca, Associate Dean for Research at WCMC-Q, said: “This handbook is a wonderful piece of scholarship that will serve as an extremely useful practical aid, both for physicians treating diabetic neuropathy and for investigators searching for viable new therapies for this condition, which can be so distressing and debilitating for sufferers.” Diabetes and the Nervous System: Handbook of Clinical Neurology is published by Elsevier Science and Technology.