Current Diabetes Reports

, Volume 12, Issue 4, pp 403–413 | Cite as

Management of Painful Diabetic Neuropathy: Guideline Guidance or Jungle?

  • Vincenza Spallone
Microvascular Complications—Neuropathy (D Ziegler, Section Editor)


The treatment of painful diabetic polyneuropathy (PDPN) remains a major challenge. A number of reasons have made the guidelines on PDPN management of particular interest, including its high prevalence, health and socioeconomic impact, interdisciplinary nature and the need for updated evidence-based information to refine patient-tailored treatment by weighing up the risks of each treatment against its proven benefits, as well as optimizing the use of all available resources. The various guidelines on the management of neuropathic pain developed so far contain some differences in their work methodology and results. Some variations in the recommendations are to be expected but could be disorienting and confusing for stakeholders. In this review, a critical evaluation of the more recent guidelines on the management of PDPN is provided together with highlights on points of agreement and disagreement as well as insights into their clinical aspects.


Painful neuropathy Neuropathic pain Diabetic neuropathy Guidelines Antidepressants SNRI Opioids Venlafaxine Duloxetine Pregabalin Gabapentin Tramadol Oxycodone Treatment 



Conflicts of interest: V. Spallone: has board membership with Wörwag Pharma, TRIGOcare International, Daiichi Sankyo Europe; has received grant support from Biocure SrL; has received payment for lectures including service on speakers bureaus from Eli-Lilly, Pfizer, Boehringer Ingelheim, Sanofi-Aventis; and has received payment for development of educational presentations from Eli-Lilly.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Endocrinology, Department of Internal MedicineTor Vergata UniversityRomeItaly

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