Pharmacotherapy of Painful Diabetic Neuropathy: A Clinical Update.
Cornelius Fernandez JamesShiva TripathiKyriaki KarampatouVasanthakumari DivyaJoseph M PappachanPublished in: Sisli Etfal Hastanesi tip bulteni (2022)
The rising prevalence of diabetes mellitus (DM) leads on to an increase in chronic diabetic complications. Diabetic peripheral neuropathies (DPNs) are common chronic complications of diabetes. Distal symmetric polyneuropathy is the most prevalent form. Most patients with DPN will remain pain-free; however, painful DPN (PDPN) occurs in 6-34% of all DM patients and is associated with reduced health-related-quality-of-life and substantial economic burden. Symptomatic treatment of PDPN and diabetic autonomic neuropathy is the key treatment goals. Using certain patient related characteristics, subjects with PDPN can be stratified and assigned targeted therapies to produce better pain outcomes. The aim of this review is to discuss the various pathogenetic mechanisms of DPN with special reference to the mechanisms leading to PDPN and the various pharmacological and non-pharmacological therapies available for its management. Recommended pharmacological therapies include anticonvulsants, antidepressants, opioid analgesics, and topical medications.
Keyphrases
- type diabetes
- chronic pain
- wound healing
- glycemic control
- pain management
- risk factors
- end stage renal disease
- cardiovascular disease
- chronic kidney disease
- ejection fraction
- newly diagnosed
- neuropathic pain
- combination therapy
- prognostic factors
- minimally invasive
- heart rate variability
- blood pressure
- skeletal muscle
- public health
- smoking cessation
- metabolic syndrome
- patient reported outcomes
- global health