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Published on: July 14, 2023

Diabetic neuropathy: new strategies for treatment

Tamás Várkonyi1, Peter Kempler

  • 1First Department of Medicine, University of Szeged, Szeged, Hungary. vart@in1st.szote.u-szeged.hu

Diabetes, Obesity & Metabolism
|June 27, 2007
PubMed

Insights

Benfotiamine and alpha-lipoic acid are recommended for diabetic neuropathy. Combination therapy, integrating pathogenetically oriented and symptomatic treatments like pregabalin and duloxetine, shows promise for managing diabetic painful neuropathy (DPN).

Area of Science:

  • Neurology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetic neuropathy presents complex therapeutic challenges.
  • Current treatments are broadly categorized into pathogenetically oriented and symptomatic approaches.
  • Effective management requires addressing underlying causes and alleviating symptoms.

Purpose of the Study:

  • To review current therapeutic strategies for diabetic neuropathy.
  • To evaluate the efficacy and safety of various treatment options.
  • To explore potential future treatment combinations.

Main Methods:

  • Literature review of current therapeutic possibilities.
  • Analysis of efficacy and safety data for key pharmacological agents.
  • Assessment of evidence for pathogenetically oriented and symptomatic treatments.

Main Results:

  • Benfotiamine and alpha-lipoic acid are recommended as first-line pathogenetically oriented treatments.
  • Pregabalin and gabapentin demonstrate high efficacy and safety for symptomatic relief.
  • Duloxetine shows beneficial effects as a symptomatic treatment for diabetic painful neuropathy (DPN).

Conclusions:

  • Combination therapy, merging pathogenetically oriented and symptomatic treatments, is likely the future of DPN management.
  • Optimizing treatment may involve combining agents like benfotiamine/alpha-lipoic acid with pregabalin/duloxetine.
  • Stabilizing glycemic control remains a crucial component of etiology-based treatment.

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