Oral and Topical Treatment of Painful Diabetic Polyneuropathy: Practice Guideline Update Summary: Report of the AAN Guideline Subcommittee.
Raymond PriceDon SmithGary FranklinGary GronsethMichael PignoneWilliam S DavidCarmel ArmonBruce A PerkinsVera BrilAlexander Rae-GrantJohn J HalperinNicole LickingMary Dolan O'BrienScott R WesselsLeslie C MacGregorKenneth FinkLawrence B HarklessLindsay ColbertBrian C CallaghanPublished in: Neurology (2022)
Clinicians should assess patients with diabetes for PDN (Level B) and those with PDN for concurrent mood and sleep disorders (Level B). In patients with PDN, clinicians should offer TCAs, SNRIs, gabapentinoids, and/or sodium channel blockers to reduce pain (Level B) and consider factors other than efficacy (Level B). Clinicians should offer patients a trial of medication from a different effective class when they do not achieve meaningful improvement or experience significant adverse effects with the initial therapeutic class (Level B) and not use opioids for the treatment of PDN (Level B).
Keyphrases
- healthcare
- palliative care
- chronic pain
- primary care
- type diabetes
- squamous cell carcinoma
- randomized controlled trial
- ejection fraction
- bipolar disorder
- radiation therapy
- clinical trial
- prognostic factors
- sleep quality
- quality improvement
- spinal cord injury
- phase iii
- patient reported outcomes
- electronic health record