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4. Painful diabetic polyneuropathy.

Xander Zuidema^1,2, Bastiaan de Galan^3,4,5, Brigitte Brouwer¹

¹Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.

Pain Practice : the Official Journal of World Institute of Pain

|October 20, 2023

Summary

This summary is machine-generated.

Painful diabetic polyneuropathy (PDPN) diagnosis is shifting towards personalized phenotyping and genotyping. Treatment for PDPN should be mechanism-based, starting early with proper glucose control and risk factor prevention.

Keywords:

anti-neuropathic drugs evidence-based medicine neuropathic pain painful diabetic polyneuropathy spinal cord stimulation

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Area of Science:

Neurology
Diabetology
Pain Management

Background:

Painful diabetic polyneuropathy (PDPN) significantly impacts patient quality of life and increases mortality.
The incidence of PDPN has risen considerably in recent decades, highlighting its growing public health significance.

Purpose of the Study:

To review and summarize current literature on the diagnosis and treatment of diabetic polyneuropathy (DPN).
To outline evolving strategies for managing PDPN, emphasizing precision medicine approaches.

Main Methods:

A comprehensive literature review was conducted on the diagnosis and treatment of diabetic polyneuropathy.
Information was synthesized to provide an overview of current and emerging clinical practices.

Main Results:

PDPN etiology is complex, involving peripheral nociceptor damage and altered central pain modulation.
Diagnosis and treatment are increasingly tailored to individual patient characteristics, including phenotyping and genotyping.
Early, mechanism-based pharmacological treatment is recommended, alongside glucose control and risk factor management.
Advanced therapies like spinal cord stimulation (SCS) and nerve stimulation techniques are considered when standard treatments fail.

Conclusions:

The diagnosis of PDPN is evolving towards phenotyping and genotyping for personalized care.
Treatment strategies for PDPN should be mechanism-based and initiated promptly.