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Therapy for diabetic neuropathy: an overview.

Bernadette Calabek¹, Brian Callaghan², Eva L Feldman²

¹Neurologische Abetilung, Kaiser Franz Josef Spital, Vienna, Austria.

Handbook of Clinical Neurology

|November 21, 2014

Summary

Diabetic neuropathy, a common diabetes complication, is best managed by controlling blood sugar and treating nerve pain with evidence-based medications. While glucose control is key for type 1 diabetes, its effect is limited for type 2, making pain management crucial.

Keywords:

Diabetic neuropathy clinical trials pain treatments

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Area of Science:

Endocrinology
Neurology
Pharmacology

Background:

Diabetic neuropathy is a prevalent complication of diabetes, with increasing incidence.
Effective disease-modifying treatment primarily involves enhanced glucose control.
Glycemic control significantly reduces neuropathy in type 1 diabetes but has a marginal effect in type 2.

Purpose of the Study:

To review the current understanding and management of diabetic neuropathy.
To highlight the importance of neuropathic pain recognition and treatment.
To discuss available and emerging pharmacological treatments for neuropathic pain.

Main Methods:

Review of randomized, controlled clinical trials.
Analysis of evidence supporting various pain reduction medications.
Discussion of treatment strategies for diabetic neuropathy.

Main Results:

Improved glycemic control is a cornerstone for preventing diabetic neuropathy, especially in type 1 diabetes.
Multiple medications, including calcium channel agonists, tricyclic antidepressants, and SNRIs, are supported by evidence for pain reduction.
Optimal sequencing and combination of pain medications remain unclear, with new treatments under development.

Conclusions:

The primary management of diabetic neuropathy involves improved glycemic control.
Initiating evidence-based neuropathic pain medication is essential when pain is present.
Further research is needed to clarify optimal pharmacological combinations and sequences.