Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus

Diabetic peripheral neuropathy is a common chronic complication of diabetes mellitus, significantly impairing well-being, quality of life and functioning of patients. The prevalence of diabetic peripheral neuropathy in the Russian Federation ranges from 0.1% to 67.2% in type 1 and from 0.1 to 42.4%...

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Autores principales:	Gagik R. Galstyan, Elena G. Starostina, Nikolay N. Yakhno, Irina V. Gurieva, Maxim V. Churyukanov, Igor A. Strokov, Alla Y. Tokmakova, Mikhail L. Kukushkin, Anatoly I. Martynov, Marina V. Shestakova
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2019
Materias:	diabetes mellitus diabetic peripheral neuropathy painful neuropathy neuropathic pain diagnosis treatment Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/76e2ab4d47454399b866be305a0ecb21
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spelling	oai:doaj.org-article:76e2ab4d47454399b866be305a0ecb212021-11-14T09:00:22ZDiagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus2072-03512072-037810.14341/DM9625https://doaj.org/article/76e2ab4d47454399b866be305a0ecb212019-10-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/9625https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Diabetic peripheral neuropathy is a common chronic complication of diabetes mellitus, significantly impairing well-being, quality of life and functioning of patients. The prevalence of diabetic peripheral neuropathy in the Russian Federation ranges from 0.1% to 67.2% in type 1 and from 0.1 to 42.4% in type 2 diabetes mellitus. However, based on the large-scale epidemiological studies, the true prevalence of diabetic peripheral neuropathy is much higher (50 to 70%), with its painful variant occurring in 16% to 30% of patients. Despite the fact that diabetic peripheral neuropathy remains the most common chronic complication of diabetes mellitus, its diagnosis and therapy leave much to be desired. To optimize diagnostic and treatment approaches to painful diabetic peripheral neuropathy, a group of experts representing the leading Russian professional medical associations has developed clinical guidelines for the diagnosis and rational therapy of patients with painful diabetic peripheral neuropathy. This document presents practical aspects of the clinical diagnosis of painful diabetic peripheral neuropathy and an algorithm for differential diagnosis of pain in the lower extremities in patients with diabetes mellitus. The use of symptomatic analgesics with central action, such as anticonvulsants, antidepressants and opioids, is based on the main aspects of neuropathic pain pathophysiology. The characteristics of each drug class are given, with consideration of evidence on their efficacy, tolerability, and the possibility of combination therapy. The data on the first, second, and third lines of agents is presented in accordance with several international clinical guidelines. The need for a tailored drug choice, taking into account the evidence-based data on their efficacy and safety, concomitant drug therapy, tolerability, cost and preferences of the patient, age of the patient and concomitant disorders, is emphasized.Gagik R. GalstyanElena G. StarostinaNikolay N. YakhnoIrina V. GurievaMaxim V. ChuryukanovIgor A. StrokovAlla Y. TokmakovaMikhail L. KukushkinAnatoly I. MartynovMarina V. ShestakovaEndocrinology Research Centrearticlediabetes mellitusdiabetic peripheral neuropathypainful neuropathyneuropathic paindiagnosistreatmentNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 22, Iss 4, Pp 305-327 (2019)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetes mellitus diabetic peripheral neuropathy painful neuropathy neuropathic pain diagnosis treatment Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetes mellitus diabetic peripheral neuropathy painful neuropathy neuropathic pain diagnosis treatment Nutritional diseases. Deficiency diseases RC620-627 Gagik R. Galstyan Elena G. Starostina Nikolay N. Yakhno Irina V. Gurieva Maxim V. Churyukanov Igor A. Strokov Alla Y. Tokmakova Mikhail L. Kukushkin Anatoly I. Martynov Marina V. Shestakova Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
description	Diabetic peripheral neuropathy is a common chronic complication of diabetes mellitus, significantly impairing well-being, quality of life and functioning of patients. The prevalence of diabetic peripheral neuropathy in the Russian Federation ranges from 0.1% to 67.2% in type 1 and from 0.1 to 42.4% in type 2 diabetes mellitus. However, based on the large-scale epidemiological studies, the true prevalence of diabetic peripheral neuropathy is much higher (50 to 70%), with its painful variant occurring in 16% to 30% of patients. Despite the fact that diabetic peripheral neuropathy remains the most common chronic complication of diabetes mellitus, its diagnosis and therapy leave much to be desired. To optimize diagnostic and treatment approaches to painful diabetic peripheral neuropathy, a group of experts representing the leading Russian professional medical associations has developed clinical guidelines for the diagnosis and rational therapy of patients with painful diabetic peripheral neuropathy. This document presents practical aspects of the clinical diagnosis of painful diabetic peripheral neuropathy and an algorithm for differential diagnosis of pain in the lower extremities in patients with diabetes mellitus. The use of symptomatic analgesics with central action, such as anticonvulsants, antidepressants and opioids, is based on the main aspects of neuropathic pain pathophysiology. The characteristics of each drug class are given, with consideration of evidence on their efficacy, tolerability, and the possibility of combination therapy. The data on the first, second, and third lines of agents is presented in accordance with several international clinical guidelines. The need for a tailored drug choice, taking into account the evidence-based data on their efficacy and safety, concomitant drug therapy, tolerability, cost and preferences of the patient, age of the patient and concomitant disorders, is emphasized.
format	article
author	Gagik R. Galstyan Elena G. Starostina Nikolay N. Yakhno Irina V. Gurieva Maxim V. Churyukanov Igor A. Strokov Alla Y. Tokmakova Mikhail L. Kukushkin Anatoly I. Martynov Marina V. Shestakova
author_facet	Gagik R. Galstyan Elena G. Starostina Nikolay N. Yakhno Irina V. Gurieva Maxim V. Churyukanov Igor A. Strokov Alla Y. Tokmakova Mikhail L. Kukushkin Anatoly I. Martynov Marina V. Shestakova
author_sort	Gagik R. Galstyan
title	Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
title_short	Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
title_full	Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
title_fullStr	Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
title_full_unstemmed	Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
title_sort	diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
publisher	Endocrinology Research Centre
publishDate	2019
url	https://doaj.org/article/76e2ab4d47454399b866be305a0ecb21
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_version_	1718429470123098112

Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus

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