[Therapy of diabetic neuropathy]

A clinical state of peripheral and autonomic nerve damage in the abnormal environment of diabetes mellitus leads to syndromes of diabetic neuropathy. Diabetic neuropathy is a complication that affects most patients with longstanding diabetes mellitus, deteriorating their quality of life. The pathogenesis of diabetic neuropathy is multifactorial. The goals of treating diabetic neuropathy are to prevent the progression and reduce the symptoms. Smooth diabetes control without the risk of hypoglycaemia is most important to prevent progression. Early treatment is suggested, because of advanced marked nerve fiber loss. Treatments are supported by several investigations in diabetic patients: aldose reductase inhibition, prevention of protein glycation, improvement of nerve and administration of neurotrophic factors. Many other medications like amitriptiline, gabapentin, and carbamazepine have been used successfully in the treatment of painful diabetic neuropathy. To reduce the symptoms, studies have also shown analgesics to be effective.