Update on the management of diabetic polyneuropathies

Jayadave Shakher1, Martin J Stevens1,21Heart of England NHS Foundation Trust, Birmingham, UK; 2School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UKAbstract: The prevalence of diabetic polyneuropathy (DPN) can approach 50% in subjects with longer-duration diabetes. T...

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Autores principales:	Shakher J, Stevens MJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/a31da84d52834d028c5dcc80ef9c0d0f
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spelling	oai:doaj.org-article:a31da84d52834d028c5dcc80ef9c0d0f2021-12-02T05:19:03ZUpdate on the management of diabetic polyneuropathies1178-7007https://doaj.org/article/a31da84d52834d028c5dcc80ef9c0d0f2011-07-01T00:00:00Zhttp://www.dovepress.com/update-on-the-management-of-diabetic-polyneuropathies-a7924https://doaj.org/toc/1178-7007Jayadave Shakher1, Martin J Stevens1,21Heart of England NHS Foundation Trust, Birmingham, UK; 2School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UKAbstract: The prevalence of diabetic polyneuropathy (DPN) can approach 50% in subjects with longer-duration diabetes. The most common neuropathies are generalized symmetrical chronic sensorimotor polyneuropathy and autonomic neuropathy. It is important to recognize that 50% of subjects with DPN may have no symptoms and only careful clinical examination may reveal the diagnosis. DPN, especially painful diabetic peripheral neuropathy, is associated with poor quality of life. Although there is a better understanding of the pathophysiology of DPN and the mechanisms of pain, treatment remains challenging and is limited by variable efficacy and side effects of therapies. Intensification of glycemic control remains the cornerstone for the prevention or delay of DPN but optimization of other traditional cardiovascular risk factors may also be of benefit. The management of DPN relies on its early recognition and needs to be individually based on comorbidities and tolerability to medications. To date, most pharmacological strategies focus upon symptom control. In the management of pain, tricyclic antidepressants, selective serotonin noradrenaline reuptake inhibitors, and anticonvulsants alone or in combination are current first-line therapies followed by use of opiates. Topical agents may offer symptomatic relief in some patients. Disease-modifying agents are still in development and to date, antioxidant &alpha;-lipoic acid has shown the most promising effect. Further development and testing of therapies based upon improved understanding of the complex pathophysiology of this common and disabling complication is urgently required.Keywords: diabetes, neuropathic pain, microvascular, glucose&nbsp;Shakher JStevens MJDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2011, Iss default, Pp 289-305 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Shakher J Stevens MJ Update on the management of diabetic polyneuropathies
description	Jayadave Shakher1, Martin J Stevens1,21Heart of England NHS Foundation Trust, Birmingham, UK; 2School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UKAbstract: The prevalence of diabetic polyneuropathy (DPN) can approach 50% in subjects with longer-duration diabetes. The most common neuropathies are generalized symmetrical chronic sensorimotor polyneuropathy and autonomic neuropathy. It is important to recognize that 50% of subjects with DPN may have no symptoms and only careful clinical examination may reveal the diagnosis. DPN, especially painful diabetic peripheral neuropathy, is associated with poor quality of life. Although there is a better understanding of the pathophysiology of DPN and the mechanisms of pain, treatment remains challenging and is limited by variable efficacy and side effects of therapies. Intensification of glycemic control remains the cornerstone for the prevention or delay of DPN but optimization of other traditional cardiovascular risk factors may also be of benefit. The management of DPN relies on its early recognition and needs to be individually based on comorbidities and tolerability to medications. To date, most pharmacological strategies focus upon symptom control. In the management of pain, tricyclic antidepressants, selective serotonin noradrenaline reuptake inhibitors, and anticonvulsants alone or in combination are current first-line therapies followed by use of opiates. Topical agents may offer symptomatic relief in some patients. Disease-modifying agents are still in development and to date, antioxidant &alpha;-lipoic acid has shown the most promising effect. Further development and testing of therapies based upon improved understanding of the complex pathophysiology of this common and disabling complication is urgently required.Keywords: diabetes, neuropathic pain, microvascular, glucose&nbsp;
format	article
author	Shakher J Stevens MJ
author_facet	Shakher J Stevens MJ
author_sort	Shakher J
title	Update on the management of diabetic polyneuropathies
title_short	Update on the management of diabetic polyneuropathies
title_full	Update on the management of diabetic polyneuropathies
title_fullStr	Update on the management of diabetic polyneuropathies
title_full_unstemmed	Update on the management of diabetic polyneuropathies
title_sort	update on the management of diabetic polyneuropathies
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/a31da84d52834d028c5dcc80ef9c0d0f
work_keys_str_mv	AT shakherj updateonthemanagementofdiabeticpolyneuropathies AT stevensmj updateonthemanagementofdiabeticpolyneuropathies
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Update on the management of diabetic polyneuropathies

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