Emerging drugs for diabetic neuropathy

Area of Science:

• Neurology
• Endocrinology
• Pharmacology

Background:

• Diabetic neuropathy (DN) is a prevalent and debilitating complication of diabetes, significantly increasing morbidity and mortality.
• Diabetic peripheral neuropathy (DPN) presents with pain in early stages, progressing to a painless state, with current treatments primarily managing symptoms rather than disease progression.
• Effective treatments to slow or reverse DPN are lacking, with good glycemic control being the only established intervention.

Purpose of the Study:

• To review the epidemiology, pathogenesis, and current/future treatments for diabetic peripheral neuropathy (DPN).
• To discuss challenges and issues in the development of novel DPN therapies.
• To provide insights into the limitations of current DPN treatment approaches and future research directions.

Main Methods:

• Comprehensive literature search using PubMed, Medline, and Pharmaprojects from 1950 onwards.
• Inclusion of search terms covering diabetic neuropathy, pathogenesis, mechanisms, treatment, oxidative stress, and emerging therapeutic targets.
• Review focused on understanding the complex multifactorial pathogenesis of DPN and its relation to therapeutic strategies.

Main Results:

• Overview of DPN epidemiology, clinical features, and risk factors.
• Enhanced understanding of DPN pathogenic mechanisms and their link to current and future therapies.
• Insight into the limitations of current DPN management and potential avenues for future research.

Conclusions:

• DN is a common, disabling complication with limited treatment options beyond glycemic control.
• DPN pathogenesis is complex and multifactorial, with oxidative and nitrosative stress identified as key factors.
• Emerging therapies include disease-modifying treatments targeting pathogenic pathways, gene therapy, and growth factors, with a focus on slowing progression.