[Management of diabetic neuropathy]

Inappropriate glycaemic control eventually induces microangiopathy and macroangiopathy in diabetic patients. To prevent these complications in particular diabetic neuropathy, early intervention to hyperglycemia is the most important. Unfortunately, possible methods for treatment of diabetic neuropathy are limited at this moment. Main medications for painful diabetic neuropathy are targeting to symptomatic cure but not to improvement of pathophysiology of this complication. Posttreatment painful neuropathy abruptly appears after acute treatment of long-suspended hyperglycemia using drugs and insulin. This self-limited disease is drug-treatment resistant in many cases. Painful neuropathy is sometimes dramatically improved with anti-depressant in case in which the patients have masked depression.