{ "schema_version": 1, "title": "Diabetic Peripheral Neuropathy Mechanism Explorer", "authors": [ "Brice Edelman", "Jeffrey Skolnick" ], "status": "Work in progress", "snapshot_date": "2026-09-14", "base_url": "https://bricee98.github.io/dpn-mechanism-explorer/", "path_base": "All paths are relative to base_url, not this JSON file.", "probability_units": "percent", "probability_meaning": "Subjective causal belief. Scenario endpoints are sensitivity products, not confidence limits.", "method_markdown": "sources/probability_method.md", "coverage_markdown": "sources/coverage.md", "report_count": 45, "claim_count": 207, "reports": [ { "id": "01", "title": "Polyol metabolism", "summary": "Excess glucose-to-sorbitol metabolism may damage terminals through altered sugar pools or cellular redox balance.", "source_title": "Excess polyol flux and impaired sorbitol disposal", "page": "01_polyol_flux.html", "source_markdown": "sources/01_polyol_flux.md", "structured_data": "data/01_polyol_flux.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 2.2815, "base": 21.133125, "favorable": 55.233 } }, { "id": "02", "title": "Glucosamine and hexosamine stress", "summary": "Naturally elevated glucosamine may disrupt nerve metabolism enough to cause terminal loss.", "source_title": "Excess glucosamine and hexosamine-associated metabolic stress", "page": "02_glucosamine_hexosamine.html", "source_markdown": "sources/02_glucosamine_hexosamine.md", "structured_data": "data/02_glucosamine_hexosamine.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.13125, "base": 5.445, "favorable": 38.08 } }, { "id": "03", "title": "Extracellular matrix glycation", "summary": "Glycation of the surrounding matrix may prevent sensory terminals from replacing ordinary losses.", "source_title": "Glycated extracellular matrix prevents terminal replacement", "page": "03_extracellular_matrix_glycation.html", "source_markdown": "sources/03_extracellular_matrix_glycation.md", "structured_data": "data/03_extracellular_matrix_glycation.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.819, "base": 15.47, "favorable": 55.233 } }, { "id": "04", "title": "RAGE signaling", "summary": "Persistent signaling through RAGE may turn local ligand exposure into structural nerve injury.", "source_title": "Persistent RAGE signaling causes structural axon injury", "page": "04_rage_signaling.html", "source_markdown": "sources/04_rage_signaling.md", "structured_data": "data/04_rage_signaling.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.30375, "base": 9.36, "favorable": 43.241625 } }, { "id": "05", "title": "Methylglyoxal and carbonyl stress", "summary": "Intracellular methylglyoxal may overwhelm clearance and repair, causing terminal injury.", "source_title": "Intracellular methylglyoxal contributes to terminal injury", "page": "05_methylglyoxal_carbonyl_stress.html", "source_markdown": "sources/05_methylglyoxal_carbonyl_stress.md", "structured_data": "data/05_methylglyoxal_carbonyl_stress.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.525, "base": 10.2375, "favorable": 45.5175 } }, { "id": "06", "title": "Glucose overload and mitochondrial superoxide", "summary": "Excess glucose-derived reducing input may drive mitochondrial superoxide production and terminal injury.", "source_title": "Glucose-driven respiratory over-reduction and superoxide", "page": "06_glucose_mitochondrial_overload.html", "source_markdown": "sources/06_glucose_mitochondrial_overload.md", "structured_data": "data/06_glucose_mitochondrial_overload.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.0590625, "base": 4.5045, "favorable": 37.58445 } }, { "id": "07", "title": "Insufficient axonal energy", "summary": "Too little usable ATP in distal sensory axons may limit maintenance and terminal survival.", "source_title": "Insufficient usable ATP in distal sensory axons", "page": "07_bioenergetic_insufficiency.html", "source_markdown": "sources/07_bioenergetic_insufficiency.md", "structured_data": "data/07_bioenergetic_insufficiency.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 4.05, "base": 33.75, "favorable": 77.16375 } }, { "id": "08", "title": "Fatty-acid delivery", "summary": "Excess fatty-acid delivery may depolarize neuronal mitochondria and contribute to terminal loss.", "source_title": "Fatty-acid delivery and neuronal mitochondrial depolarization", "page": "08_fatty_acid_delivery.html", "source_markdown": "sources/08_fatty_acid_delivery.md", "structured_data": "data/08_fatty_acid_delivery.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.4134375, "base": 12.4215, "favorable": 55.7685 } }, { "id": "09", "title": "Oxidized LDL", "summary": "Oxidized LDL may act through neuronal LOX-1 and NADPH oxidase to damage sensory terminals.", "source_title": "Oxidized LDL, neuronal LOX-1 and NADPH-oxidase injury", "page": "09_oxidized_ldl.html", "source_markdown": "sources/09_oxidized_ldl.md", "structured_data": "data/09_oxidized_ldl.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.05859375, "base": 4.492125, "favorable": 41.7605 } }, { "id": "10", "title": "Deoxysphingolipids", "summary": "Local deoxysphingolipid accumulation may expose sensory neurons and their support cells to harmful lipids.", "source_title": "Deoxysphingolipid accumulation in the sensory-neuron unit", "page": "10_serine_deoxysphingolipids.html", "source_markdown": "sources/10_serine_deoxysphingolipids.md", "structured_data": "data/10_serine_deoxysphingolipids.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.945, "base": 19.22375, "favorable": 65.61 } }, { "id": "11", "title": "Canonical ceramides", "summary": "Excess ceramides in neurons or Schwann cells may contribute to structural terminal loss.", "source_title": "Excess canonical ceramides in neurons or Schwann cells", "page": "11_canonical_ceramides.html", "source_markdown": "sources/11_canonical_ceramides.md", "structured_data": "data/11_canonical_ceramides.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.375, "base": 10.814375, "favorable": 55.27125 } }, { "id": "12", "title": "Insulin and IGF support", "summary": "Loss of physiological insulin or IGF signaling in sensory neurons may remove support needed for terminal survival.", "source_title": "Loss of neuronal insulin/IGF trophic support", "page": "12_insulin_igf_trophic_deficit.html", "source_markdown": "sources/12_insulin_igf_trophic_deficit.md", "structured_data": "data/12_insulin_igf_trophic_deficit.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.675, "base": 15.21, "favorable": 58.5225 } }, { "id": "13", "title": "C-peptide deficiency", "summary": "Loss of C-peptide in type 1 diabetes may remove a source of support for peripheral nerve terminals.", "source_title": "C-peptide deficiency removes nerve support", "page": "13_c_peptide_deficiency.html", "source_markdown": "sources/13_c_peptide_deficiency.md", "structured_data": "data/13_c_peptide_deficiency.json", "source_review_date": "2026-09-14", "scope_label": "Type 1 diabetes", "scope_exception": true, "probability_percent": { "skeptical": 1.4, "base": 18.5625, "favorable": 63.954 } }, { "id": "14", "title": "NGF and TrkA support", "summary": "Insufficient target-derived NGF signaling through TrkA may limit sensory terminal maintenance.", "source_title": "Insufficient target-derived NGF/TrkA support", "page": "14_ngf_trophic_support.html", "source_markdown": "sources/14_ngf_trophic_support.md", "structured_data": "data/14_ngf_trophic_support.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.75, "base": 16.0875, "favorable": 61.77375 } }, { "id": "15", "title": "Microvascular oxygen and fuel supply", "summary": "Impaired microvascular exchange may restrict the oxygen or fuel reaching sensory neurons.", "source_title": "Inadequate microvascular oxygen or fuel delivery", "page": "15_microvascular_ischemia.html", "source_markdown": "sources/15_microvascular_ischemia.md", "structured_data": "data/15_microvascular_ischemia.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.4725, "base": 15.35625, "favorable": 65.79225 } }, { "id": "16", "title": "Vascular PKC signaling", "summary": "Excess DAG-dependent vascular PKCβ activity may reduce local nerve supply and cause terminal loss.", "source_title": "DAG-dependent vascular PKCβ activity reduces nerve supply", "page": "16_pkc_vascular_signaling.html", "source_markdown": "sources/16_pkc_vascular_signaling.md", "structured_data": "data/16_pkc_vascular_signaling.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.0216, "base": 5.0977265625, "favorable": 47.534900625 } }, { "id": "17", "title": "Schwann-cell metabolic support", "summary": "Abnormal metabolic output from Remak Schwann cells may injure the unmyelinated axons they support.", "source_title": "Abnormal Remak Schwann-cell metabolic output injures unmyelinated axons", "page": "17_schwann_metabolic_support.html", "source_markdown": "sources/17_schwann_metabolic_support.md", "structured_data": "data/17_schwann_metabolic_support.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.3645, "base": 13.182, "favorable": 62.3295 } }, { "id": "18", "title": "Glial mitochondrial transfer", "summary": "Insufficient or poor-quality mitochondrial supply from satellite glia may undermine sensory-neuron maintenance.", "source_title": "Insufficient or low-quality mitochondrial supply from satellite glia", "page": "18_satellite_glial_mitochondrial_transfer.html", "source_markdown": "sources/18_satellite_glial_mitochondrial_transfer.md", "structured_data": "data/18_satellite_glial_mitochondrial_transfer.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.09375, "base": 7.8975, "favorable": 52.326 } }, { "id": "19", "title": "TNF and TLR4 inflammation", "summary": "Excess local TNF- or TLR4-associated signaling may cause structural terminal injury.", "source_title": "Excess peripheral TNF-receptor or TLR4 signaling", "page": "19_tnf_tlr4_inflammation.html", "source_markdown": "sources/19_tnf_tlr4_inflammation.md", "structured_data": "data/19_tnf_tlr4_inflammation.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.81, "base": 19.22375, "favorable": 69.255 } }, { "id": "20", "title": "Protective macrophage function", "summary": "Loss of macrophage clearance capacity may allow damaging material to accumulate around sensory neurons.", "source_title": "Failure of macrophage dead-cell clearance", "page": "20_loss_of_protective_macrophages.html", "source_markdown": "sources/20_loss_of_protective_macrophages.md", "structured_data": "data/20_loss_of_protective_macrophages.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.1875, "base": 7.92, "favorable": 52.02 } }, { "id": "21", "title": "Inflammasomes and pyroptosis", "summary": "Inflammasome activation may produce gasdermin-D pores that cause local injury and terminal loss.", "source_title": "NLRP3-associated gasdermin-D membrane injury", "page": "21_inflammasome_pyroptosis.html", "source_markdown": "sources/21_inflammasome_pyroptosis.md", "structured_data": "data/21_inflammasome_pyroptosis.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.08203125, "base": 6.318, "favorable": 55.7685 } }, { "id": "22", "title": "Complement-mediated injury", "summary": "Terminal complement assembly may damage local vascular or glial membranes and compromise sensory terminals.", "source_title": "Complement-mediated vascular or glial membrane injury", "page": "22_complement_microvascular_injury.html", "source_markdown": "sources/22_complement_microvascular_injury.md", "structured_data": "data/22_complement_microvascular_injury.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.140625, "base": 8.424, "favorable": 55.7685 } }, { "id": "23", "title": "Endoplasmic reticulum stress", "summary": "A persistently harmful endoplasmic reticulum stress response may exceed adaptation and contribute to terminal loss.", "source_title": "Persistent ER-sensor signaling impairs terminal maintenance", "page": "23_er_stress.html", "source_markdown": "sources/23_er_stress.md", "structured_data": "data/23_er_stress.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.63, "base": 16.26625, "favorable": 65.4075 } }, { "id": "24", "title": "Autophagy and mitophagy", "summary": "Slow completion of cellular cargo clearance may allow damage to outpace axonal maintenance.", "source_title": "Slow completion of intracellular autophagic disposal", "page": "24_autophagy_mitophagy.html", "source_markdown": "sources/24_autophagy_mitophagy.md", "structured_data": "data/24_autophagy_mitophagy.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.3375, "base": 10.725, "favorable": 55.27125 } }, { "id": "25", "title": "Mitochondrial dynamics", "summary": "Abnormal mitochondrial fission, fusion, or distribution may compromise the maintenance of sensory terminals.", "source_title": "Abnormal mitochondrial fission or fusion impairs terminal maintenance", "page": "25_mitochondrial_dynamics.html", "source_markdown": "sources/25_mitochondrial_dynamics.md", "structured_data": "data/25_mitochondrial_dynamics.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.63, "base": 16.26625, "favorable": 61.965 } }, { "id": "26", "title": "Axonal transport", "summary": "Impaired cargo transport may create a distal imbalance that limits terminal maintenance and survival.", "source_title": "Impaired axonal transport creates a local cargo imbalance", "page": "26_axonal_transport.html", "source_markdown": "sources/26_axonal_transport.md", "structured_data": "data/26_axonal_transport.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.3675, "base": 14.3325, "favorable": 62.3295 } }, { "id": "27", "title": "SARM1 axon destruction", "summary": "Excess SARM1 activity in diabetic axons may activate a program of axon destruction.", "source_title": "SARM1 catalytic activity contributes to terminal destruction", "page": "27_sarm1_axon_destruction.html", "source_markdown": "sources/27_sarm1_axon_destruction.md", "structured_data": "data/27_sarm1_axon_destruction.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 2.480625, "base": 36.0, "favorable": 77.16375 } }, { "id": "28", "title": "PARP and NAD depletion", "summary": "Excess PARP1 activity may drain resources needed for axonal maintenance and contribute to terminal loss.", "source_title": "Excess PARP1 catalysis contributes to terminal loss", "page": "28_parp_nad_depletion.html", "source_markdown": "sources/28_parp_nad_depletion.md", "structured_data": "data/28_parp_nad_depletion.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 1.47, "base": 23.8875, "favorable": 65.4075 } }, { "id": "29", "title": "Ferroptotic injury", "summary": "Iron-dependent phospholipid peroxidation may cause structural injury to the sensory-neuron unit.", "source_title": "Iron-dependent lipid peroxidation causes ferroptotic membrane injury", "page": "29_ferroptosis.html", "source_markdown": "sources/29_ferroptosis.md", "structured_data": "data/29_ferroptosis.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.0875, "base": 7.605, "favorable": 47.0934 } }, { "id": "30", "title": "Sensory-neuron cell-body apoptosis", "summary": "Completed apoptosis of a sensory-neuron cell body may cause loss of its distal terminals.", "source_title": "Somal apoptotic execution contributes to terminal loss", "page": "30_neuronal_soma_apoptosis.html", "source_markdown": "sources/30_neuronal_soma_apoptosis.md", "structured_data": "data/30_neuronal_soma_apoptosis.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.13125, "base": 8.281, "favorable": 51.7809375 } }, { "id": "31", "title": "Excitability and cation loading", "summary": "Excess electrogenic cation entry may exceed the neuron's capacity to manage ions and energy, damaging terminals.", "source_title": "Excess electrogenic cation entry contributes to terminal loss", "page": "31_hyperexcitability_calcium.html", "source_markdown": "sources/31_hyperexcitability_calcium.md", "structured_data": "data/31_hyperexcitability_calcium.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.4725, "base": 13.73125, "favorable": 61.965 } }, { "id": "32", "title": "The skin repair environment", "summary": "Altered skin matrix and trophic support may prevent durable replacement of lost sensory terminals.", "source_title": "Altered skin matrix and trophic support restrict terminal replacement", "page": "32_skin_repair_environment.html", "source_markdown": "sources/32_skin_repair_environment.md", "structured_data": "data/32_skin_repair_environment.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.8421875, "base": 16.016, "favorable": 62.137125 } }, { "id": "33", "title": "Senescence-like cell states", "summary": "Inflammatory proteins and matrix-remodeling enzymes released by persistent senescence-like cells may contribute to terminal loss.", "source_title": "Persistent senescence-like secretory signaling contributes to terminal loss", "page": "33_senescence_sasp.html", "source_markdown": "sources/33_senescence_sasp.md", "structured_data": "data/33_senescence_sasp.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.13125, "base": 9.75975, "favorable": 62.3295 } }, { "id": "34", "title": "Microbiome-derived exposures", "summary": "Abnormal gut-derived metabolite or LPS output may alter local nerve exposure and contribute to terminal loss.", "source_title": "Altered gut-derived chemical exposure contributes to terminal loss", "page": "34_microbiome_metabolites.html", "source_markdown": "sources/34_microbiome_metabolites.md", "structured_data": "data/34_microbiome_metabolites.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.118125, "base": 7.98525, "favorable": 58.86675 } }, { "id": "35", "title": "Rapid glycemic correction", "summary": "Rapid correction of prolonged severe hyperglycemia may cause acute small-fiber injury that slower correction could partly prevent.", "source_title": "Rapid correction of chronic hyperglycemia precipitates structural small-fiber injury", "page": "35_rapid_glycemic_correction.html", "source_markdown": "sources/35_rapid_glycemic_correction.md", "structured_data": "data/35_rapid_glycemic_correction.json", "source_review_date": "2026-09-14", "scope_label": "Post-correction neuropathy · Six months", "scope_exception": true, "probability_percent": { "skeptical": 0.39375, "base": 16.016, "favorable": 62.137125 } }, { "id": "36", "title": "Compression and mechanical injury", "summary": "Compression or stretch may cause greater terminal loss in people with early diabetes than in matched people without diabetes at the same load.", "source_title": "Mechanical loading and reduced nerve tolerance in early diabetes", "page": "36_mechanical_compression.html", "source_markdown": "sources/36_mechanical_compression.md", "structured_data": "data/36_mechanical_compression.json", "source_review_date": "2026-09-14", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.063, "base": 6.5065, "favorable": 52.326 } }, { "id": "37", "title": "Metformin-associated B12 deficiency", "summary": "Metformin-associated intracellular B12 cofactor deficits may contribute to additional terminal loss, including progression of existing neuropathy.", "source_title": "Metformin-associated B12 deficiency and further terminal loss", "page": "37_metformin_b12_deficiency.html", "source_markdown": "sources/37_metformin_b12_deficiency.md", "structured_data": "data/37_metformin_b12_deficiency.json", "source_review_date": "2026-09-14", "scope_label": "Long-term metformin · Onset or progression", "scope_exception": true, "probability_percent": { "skeptical": 0.5355, "base": 18.5367, "favorable": 68.56245 } }, { "id": "38", "title": "Kidney failure and uremic exposure", "summary": "Retained solutes in advanced kidney disease may reach sensory nerves and contribute to additional terminal loss, including progression of existing neuropathy.", "source_title": "Renal retention and additional terminal loss in advanced CKD", "page": "38_kidney_failure_uremic_exposure.html", "source_markdown": "sources/38_kidney_failure_uremic_exposure.md", "structured_data": "data/38_kidney_failure_uremic_exposure.json", "source_review_date": "2026-09-14", "scope_label": "Advanced kidney disease · Onset or progression", "scope_exception": true, "probability_percent": { "skeptical": 0.675, "base": 23.8818125, "favorable": 68.56245 } }, { "id": "39", "title": "Oxidative and nitrosative injury", "summary": "Local oxidant and nitrosative damage may exceed the nerve's capacity for defense and repair.", "source_title": "Oxidant and nitrosative damage exceeds defense and repair", "page": "39_oxidative_nitrosative_injury.html", "source_markdown": "sources/39_oxidative_nitrosative_injury.md", "structured_data": "data/39_oxidative_nitrosative_injury.json", "source_review_date": "2026-09-13", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 6.05, "base": 37.57, "favorable": 72.876875 } }, { "id": "40", "title": "Persistent regulatory memory", "summary": "A persistent gene-regulatory state may sustain nerve injury after the initiating diabetic exposure improves.", "source_title": "Persistent gene regulation sustains injury after the exposure improves", "page": "40_epigenetic_memory.html", "source_markdown": "sources/40_epigenetic_memory.md", "structured_data": "data/40_epigenetic_memory.json", "source_review_date": "2026-09-13", "scope_label": "After exposure improves", "scope_exception": true, "probability_percent": { "skeptical": 0.0875, "base": 3.290625, "favorable": 30.6 } }, { "id": "41", "title": "Hypoglycemic energy failure", "summary": "Deep or sustained hypoglycemia may exhaust available axonal fuel and cause terminal injury.", "source_title": "Deep or sustained hypoglycemia exhausts axonal fuel", "page": "41_hypoglycemic_energy_failure.html", "source_markdown": "sources/41_hypoglycemic_energy_failure.md", "structured_data": "data/41_hypoglycemic_energy_failure.json", "source_review_date": "2026-09-13", "scope_label": "Deep or sustained hypoglycemia", "scope_exception": true, "probability_percent": { "skeptical": 1.421875, "base": 18.2325, "favorable": 51.68 } }, { "id": "42", "title": "Glycemic variability", "summary": "Glucose fluctuations may add structural injury beyond the effects of average exposure and hypoglycemia.", "source_title": "Glucose fluctuations add injury beyond average exposure", "page": "42_glycemic_variability.html", "source_markdown": "sources/42_glycemic_variability.md", "structured_data": "data/42_glycemic_variability.json", "source_review_date": "2026-09-13", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.72, "base": 11.475, "favorable": 45.421875 } }, { "id": "43", "title": "Protective lipid deficiency", "summary": "Insufficient protective membrane lipids or lipid mediators may leave sensory terminals vulnerable to loss.", "source_title": "Insufficient protective membrane lipids and lipid mediators", "page": "43_protective_lipid_deficiency.html", "source_markdown": "sources/43_protective_lipid_deficiency.md", "structured_data": "data/43_protective_lipid_deficiency.json", "source_review_date": "2026-09-13", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 0.65625, "base": 11.61875, "favorable": 43.35 } }, { "id": "44", "title": "Intrinsic limits on axon regrowth", "summary": "Growth restraint within surviving neurons may prevent adequate terminal replacement in established DPN.", "source_title": "Intrinsic growth restraint prevents adequate terminal replacement", "page": "44_intrinsic_growth_restriction.html", "source_markdown": "sources/44_intrinsic_growth_restriction.md", "structured_data": "data/44_intrinsic_growth_restriction.json", "source_review_date": "2026-09-13", "scope_label": "Repair in established DPN", "scope_exception": true, "probability_percent": { "skeptical": 1.575, "base": 19.0125, "favorable": 55.27125 } }, { "id": "45", "title": "Amylin aggregation", "summary": "Harmful aggregated amylin species may reach sensory neurons and act as a circulating peptide toxin.", "source_title": "Aggregated amylin exposes sensory neurons to a circulating peptide toxin", "page": "45_amylin_aggregation.html", "source_markdown": "sources/45_amylin_aggregation.md", "structured_data": "data/45_amylin_aggregation.json", "source_review_date": "2026-09-13", "scope_label": "Early type 2 diabetes", "scope_exception": false, "probability_percent": { "skeptical": 1.0, "base": 20.25, "favorable": 55.08 } } ] }