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Treatment of Painful Diabetic Neuropathy

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Diabetic Neuropathy

Part of the book series: Clinical Diabetes ((CLD))

Abstract

Up to 50% of patients with chronic sensorimotor diabetic neuropathy will experience painful or uncomfortable symptoms, and of these a significant minority may require pharmacological therapy. As painful symptomatology may be worsened by a sudden change in glycaemic control, the first step in management should be the quest for stable, near normal glycaemic control avoiding glycaemic flux. Of all the disease-modifying treatments, only alpha-lipoic acid appears to be promising in the management of neuropathic pain, although this only licensed in certain European countries. Several groups of pharmacological agents have been proved to be efficacious in symptomatic relief in diabetic neuropathy: these include the tricyclic drugs, a number of anti-convulsants, and certain other pharmacological treatments. Although helpful in many cases, the tricyclic drugs are plagued by frequent and predictable side effects. The anti-convulsants, gabapentin and pregabalin are useful in the management of neuropathic pain, and the dual 5-HT and norepinephrine reuptake inhibitor duloxetine has also demonstrated efficacy. Although many topical and non-pharmacological treatments have been proposed, few have proven efficacy in appropriately designed controlled trials.

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Authors and Affiliations

  1. Department of Medicine, Manchester Royal Infirmary, Manchester, UK

    Andrew J. M. Boulton MD, DSc(hon), FRCP

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  1. Andrew J. M. Boulton MD, DSc(hon), FRCP
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Editors and Affiliations

  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

    Aristidis Veves MD, DSc

  2. Manchester Royal Infirmary and University of Manchester, Manchester, UK

    Rayaz A. Malik MBChB, PhD

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© 2007 Humana Press Inc., Totowa, NJ

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Boulton, A.J.M. (2007). Treatment of Painful Diabetic Neuropathy. In: Veves, A., Malik, R.A. (eds) Diabetic Neuropathy. Clinical Diabetes. Humana Press. https://doi.org/10.1007/978-1-59745-311-0_21

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  • DOI: https://doi.org/10.1007/978-1-59745-311-0_21

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-626-9

  • Online ISBN: 978-1-59745-311-0

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