A Review on Diabetic Peripheral Neuropathy
Abstract
Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes affecting over 90% of the diabetic patients. Due to the toxic effects of hyperglycemia there is development of this complication. It is typically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. Hence DPN is often inadequately treated, and the role of improving glycaemic control in diabetes. Major international clinical guidelines for the management of DPN recommend several symptomatic treatments. First-line therapies include tricyclic antidepressants, serotonin–noradrenaline reuptake inhibitors, and anti-consultants that act on calcium channels. Other therapies include opioids and topical agents such as capsaicin and lidocaine. The objectives of this paper are to review current guidelines for the pharmacological management of DPN.
Keywords: DPN, hyperglycemia, depression, lidocaine
Keywords:
DPN, hyperglycemia, depression, lidocaine
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References
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13. Chokroverty S, Reyes MG, Rubino FA, et al. The syndrome of diabetic amyotrophy. Ann Neurol. 1977; 2:131.
14. Shakher J, Stevens MJ. Updates on the management of diabetic polyneuropathies. Diabetes, Metabolic Syndrome and Obesity: Targets and Thearay 2011; 4:289-305 [Dovepress: 117.240.133.202]
15. Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature. 2001; 414:813–820.
16. Singh R, Barden A, Mori T, Beilin L. Advanced glycation end products: a review. Diabetologia. 2001; 44:129–146.
17. Vinik AI, Erbas T, Park TS, Stansberry KB, Scanelli JA, Pittenger GL. Dermal neurovascular dysfunction in type 2 diabetes. Diabetes Care. 2001; 24:1468–1475.
18. Selvin E, Hicks CW. Epidemiology of Peripheral neuropathy and lower Extremity Disease in Diabetes. Curr Down Rep; 19(10):86. DOI: 10.1007/s11892-019-1212-8 [Author manuscript]
19. Onakpoya IJ, Thomas ET, Lee JJ, Goldacre B, Heneghan CJ. Benefits and harms of pregabalin in the management of neuropathic pain: a rapid review and meta-analysis of randomised clinical trials. BMJ Open. 2019; 9(1):e02360010.1136/bmjopen-2018-023600
20. Ormseth MJ, Scholz BA, Boomershine CS. Duloxetine in the management of diabetic peripheral neuropathic pain. Patient Prefer Adherence. 2011; 5:343–356.10.2147/PPA.S16358 [PubMed: 21845034]
21. Kvinesdal B, Molin J, Froland A, Gram LF. Imipramine treatment of painful diabetic neuropathy. JAMA. 1984; 251(13):1727–1730 [PubMed: 6366276]
22. Max MB, Culnane M, Schafer SC, Gracely RH, Walther DJ, Smoller B, et al. Amitriptyline relieves diabetic neuropathy pain in patients with normal or depressed mood. Neurology. 1987; 37(4):589–596.10.1212/wnl.37.4.589 [PubMed: 2436092]
23. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000; 321:405–412. [PMC free article] [PubMed] [Google Scholar]
24. Epidemiology of Diabetes Interventions and Complications (EDIC) Design, implementation, and preliminary results of a long-term follow-up of the Diabetes Control and Complications Trial cohort. Diabetes Care. 1999; 22:99–111. [PMC free article] [PubMed] [Google Scholar]
25. Freeman R. New and developing drugs for the treatment of neuropathic pain in diabetes. CurrDiab Rep 2013; 13:500-508 [PMID: 23771401 DOI: 10.1007/s11892-013-0396-6]
26. Peltier A, Goutman SA, Callaghan BC. Painful diabetic neuropathy. BMJ 2014; 348:g1799 [PMID: 24803311 DOI: 10.1136/bmj.g1799]
27. Verma V, Singh N, Singh Jaggi A. Pregabalin in neuropathic pain: evidences and possible mechanisms. Curr Neuropharmacol 2014; 12:44-56 [PMID: 24533015
DOI: 10.2174/1570159X1201140117162802]
28. Blommel ML, Blommel AL. Pregabalin: an antiepileptic agent useful for neuropathic pain. Am J Health Syst Pharm 2007; 64:1475-1482 [PMID: 17617497 DOI: 10.2146/ajhp060371]
29. Guy S, Mehta S, Leff L, Teasell R, Loh E. Anticonvulsant medication use for the management of pain following spinal cord injury: systematic review and effectiveness analysis. Spinal Cord. 2014; 52:89-96
[PMID: 24296804 DOI: 10.1038/sc.2013.146]
30. Stahl SM, Porreca F, Taylor CP, Cheung R, Thorpe AJ, Clair A. The diverse therapeutic actions of pregabalin: is a single mechanism responsible for several pharmacological activities? Trends PharmacolSci 2013; 34:332-339
[PMID: 23642658 DOI:10.1016/j.tips.2013.04.001]
31. Zilliox L, Russell JW. Treatment of diabetic sensory polyneuropathy. Curr Treat Options Neurol 2011; 13:143-159 [PMID: 21274758 DOI: 10.1007/s11940-011-0113-1]
32. Patel N, Mishra V, Patel P, Dikshit RK. A study of the use of carbamazepine, pregabalin and alpha lipoic acid in patients of diabetic neuropathy. J Diabetes MetabDisord 2014; 13:62 [PMID:24926454 DOI: 10.1186/2251-6581-13-62]
33. Tesfaye S, Boulton AJ, Dickenson AH. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care 2013; 36:2456-2465 [PMID: 23970715 DOI: 10.2337/dc12-1964]
34. Schreiber AK, Nones CFM, Reis RC, Chichorro JG, Cunha JM. Diabetic neuropathic pain: Physiopathology and treatment. World J Diabetes 2015; 6(3):432-444
[DOI: 10.4239/wjd.v6.i3.432]
35. Cameron NE, Eaton SE, Cotter MA, Tesfaye S. Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy. Diabetologia 2001; 44:1973-1988
[PMID: 11719828 DOI: 10.1007/s001250100001]
36. Saarto T, Wiffen PJ. Antidepressants for neuropathic pain: a Cochrane review. J NeurolNeurosurg Psychiatry 2010; 81:1372-1373 [PMID: 20543189 DOI: 10.1136/jnnp.2008.144964]
37. Page N, Deluca J, Crowell K. Clinical inquiry: what medications are best for diabetic neuropathic pain? J FamPract 2012; 61:691-693 [PMID: 23256101]
38. Harati Y, Gooch C, Swenson M, Edelman S, Greene D, Raskin P, Donofrio P, Cornblath D, Sachdeo R, Siu CO, Kamin M. Double-blind randomized trial of tramadol for the treatment of the pain of diabetic neuropathy. Neurology 1998; 50:1842-1846 [PMID: 9633738]
39. Afilalo M, Morlion B. Efficacy of tapentadol ER for managing moderate to severe chronic pain. Pain Physician 2013; 16:27-40 [PMID: 23340531]
40. Taylor R, Pergolizzi JV, Raffa RB. Tapentadol extended release for chronic pain patients. AdvTher 2013; 30:14-27 [PMID: 23328938 DOI: 10.1007/s12325-013-0002-y]
41. Schwartz S, Etropolski M, Shapiro DY, Okamoto A, Lange R, Haeussler J, Rauschkolb C. Safety and efficacy of tapentadol ER in patients with painful diabetic peripheral neuropathy: results of a randomized-withdrawal, placebo-controlled trial. Curr Med Res Opin 2011; 27:151-162 [PMID: 21162697 DOI: 10.1185/03007995.2010.537589]
42. Peltier A, Goutman SA, Callaghan BC. Painful diabetic neuropathy. BMJ 2014; 348:g1799 [PMID: 24803311 DOI: 10.1136/bmj.g1799]
43. Deli G, Bosnyak E, Pusch G, Komoly S, Feher G. Diabetic neuropathies: diagnosis and management. Neuroendocrinology 2013; 98:267-280 [PMID: 24458095 DOI: 10.1159/000358728]
44. Zilliox L, Russell JW. Treatment of diabetic sensory polyneuropathy. Curr Treat Options Neurol 2011; 13:143-159 [PMID: 21274758 DOI: 10.1007/s11940-011-0113-1]
45. Groninger H, Schisler RE. Topical capsaicin for neuropathic pain #255. J Palliat Med 2012; 15:946-947 [PMID: 22849599 DOI:10.1089/jpm.2012.9571]
46. Wolff RF, Bala MM, Westwood M, Kessels AG, Kleijnen J. 5% lidocaine medicated plaster in painful diabetic peripheral neuropathy (DPN): a systematic review. Swiss Med Wkly 2010; 140:297-306 [PMID: 20458651]
47. Casale R, Mattia C. Building a diagnostic algorithm on localized neuropathic pain (LNP) and targeted topical treatment: focus on 5% lidocaine-medicated plaster. TherClin Risk Manag 2014; 10:259-268 [PMID: 24790451 DOI: 10.2147/TCRM.S58844]
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Ray J, Sahoo CK, Mohanty R, Sahoo R, Dalai R. A Review on Diabetic Peripheral Neuropathy. JDDT [Internet]. 15Apr.2021 [cited 17Apr.2024];11(2-S):121-5. Available from: https://jddtonline.info/index.php/jddt/article/view/4642
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