Pharmacological treatment of diabetic peripheral neuropathy: challenges and possibilities

Peripheral neuropathy is a well-recognised late complication in both insulin-dependent and non-insulin-dependent diabetes. However, its exact cause remains unknown. Various pathogenic mechanisms have been proposed as an explanation for the development of nerve fibre damage and associated sensory loss in this disease. As a result, many kinds of drugs are currently under evaluation for the treatment of diabetic peripheral neuropathy. This paper describes the rationale behind the usage of all these drugs and reviews major clinical and preclinical results published so far. Supplementary intake of such natural, non-toxic compounds as vitamin constituents, linoleic acid and flavonoids is encouraged, as well as strict control of hyperglycaemia, until the efficacy of one or another experimental drug is established.