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Peripheral diabetic neuropathy: current concepts in treatment
1Pharmacy Department, St Paul's Hospital (Grey Nuns), Saskatoon, Saskatchewan.
The Annals of Pharmacotherapy
|July 1, 1995
Summary
Diabetic peripheral neuropathy (PN) affects many people with diabetes, often causing uncomfortable sensations. Current treatments for PN are largely unsatisfactory, emphasizing prevention through glycemic control and symptom management.
Area of Science:
- Neurology
- Endocrinology
- Pharmacology
Background:
- Diabetic peripheral neuropathy (PN) affects 5-50% of individuals with diabetes.
- Common symptoms include tingling or burning sensations in the extremities and loss of vibratory sense.
- Existing treatments for PN have been largely unsatisfactory.
Purpose of the Study:
- To review the pathophysiology of diabetic peripheral neuropathy (PN).
- To examine current treatment concepts for diabetic peripheral neuropathy (PN).
Main Methods:
- Literature search of MEDLINE (1976-1994) and reference lists.
- Inclusion of clinical trials with adequate patient numbers and review articles.
- Selection of significant information for discussion.
Main Results:
- Glycemic control may slow PN progression; hyperglycemia is linked to decreased pain threshold.
- Aldose reductase inhibitors show potential for improving neurologic function.
- Antidepressants, lidocaine, mexiletine, capsaicin, and anticonvulsants offer symptomatic relief for pain/paresthesia.
Conclusions:
- Treatment for established PN remains unsatisfactory.
- Prevention through glycemic control is crucial.
- Symptomatic treatment of existing PN is recommended.