Update on the Management of Diabetic Neuropathy

Diabetes Spectrum : a Publication of the American Diabetes Association
Lynn AngRodica Pop-Busui

Abstract

IN BRIEF Distal symmetric polyneuropathy (DSPN) and diabetic autonomic neuropathies, particularly cardiovascular autonomic neuropathy (CAN), are prevalent diabetes complications with high morbidity, mortality, and amputation risks. The diagnosis of DSPN is principally a clinical one based on the presence of typical symptoms combined with symmetrical, distal-to-proximal stocking-glove sensory loss. CAN is an independent risk factor for cardiovascular mortality, arrhythmia, silent ischemia, major cardiovascular events, and myocardial dysfunction. Screening for CAN in high-risk patients is recommended. Symptoms of gastroparesis are nonspecific and do not correspond with its severity. Diagnosis of gastroparesis should exclude other factors well documented to affect gastric emptying such as hyperglycemia, hypoglycemia, and certain medications. There is a lack of treatment options targeting the neuropathic disease state. Managing neuropathic pain also remains a challenge. Given the high risk of addiction, abuse, psychosocial issues, and mortality, opioids are not recommended as first-, second-, or third-line agents for treating painful DSPN.

References

Sep 30, 1993·The New England Journal of Medicine·UNKNOWN Diabetes Control and Complications Trial Research GroupC Siebert
Jan 31, 2003·The New England Journal of Medicine·Peter GaedeOluf Pedersen
Sep 28, 2005·Diabetes Care·Loretta VileikyteAndrew J M Boulton
Jan 31, 2006·Diabetes Care·Catherine L MartinUNKNOWN DCCT/EDIC Research Group
Mar 29, 2006·Diabetes Care·Mercedes R CarnethonUNKNOWN Diabetes Prevention Program Research Group
Jun 27, 2006·Journal of Diabetes and Its Complications·Stefano BalducciFrancesco Fallucca
Apr 1, 2008·Diabetes Care·Sabita S Soedamah-MuthuUNKNOWN EURODIAB Prospective Complications Study Group
Jul 27, 2010·Diabetes Research and Clinical Practice·Liang S Tan
Nov 17, 2011·The American Journal of Gastroenterology·Rok Seon ChoungNicholas J Talley
Jan 25, 2012·Gait & Posture·S MorrisonA I Vinik
May 23, 2012·Lancet Neurology·Brian C CallaghanEva L Feldman
Aug 21, 2014·Current Diabetes Reports·Lynn AngRodica Pop-Busui
Aug 22, 2014·Lancet Neurology·Troels S Jensen, Nanna B Finnerup
Dec 6, 2014·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Dwight MoulinUNKNOWN Canadian Pain Society
Dec 11, 2014·Annals of Clinical and Translational Neurology·John R SingletonAlbert G Smith
Jan 13, 2015·Lancet Neurology·Nanna B FinnerupMark Wallace
Feb 19, 2015·Journal of Diabetes and Its Complications·Lindsay A ZillioxJames W Russell
Mar 15, 2015·Diabetes Care·Steven J BrownNeil D Reeves
Jun 21, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Steven OrlovBruce A Perkins
Apr 5, 2016·Journal of Diabetes and Its Complications·Kevin M WheelockRodica Pop-Busui

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Citations

Jun 15, 2020·Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing·Nur IzguDemet Corapcıoglu
Jun 28, 2019·Therapeutic Advances in Gastroenterology·Theresa MeldgaardAsbjørn Mohr Drewes
Jan 13, 2021·Medical & Biological Engineering & Computing·Hamza HassanThomas Abell
Mar 25, 2021·Nursing·Joyce K Anastasi, Chloe Klug
Aug 28, 2021·International Journal of Molecular Sciences·Eunwoo Cho, Woojin Kim
Nov 27, 2019·The Ocular Surface·Shyam Sunder TummanapalliMaria Markoulli
Jan 14, 2022·Journal of Basic and Clinical Physiology and Pharmacology·Fathima Nafha NizamdeenMd Anzar Alam

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Methods Mentioned

BETA
amputation
pharmacotherapies

Software Mentioned

NeuroQol

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