Diabetes: how to manage diabetic peripheral neuropathy.
anticonvulsants
antidepressants
diabetes
hyperglycaemia
neuropathy
pain
Journal
Drugs in context
ISSN: 1745-1981
Titre abrégé: Drugs Context
Pays: England
ID NLM: 101262187
Informations de publication
Date de publication:
2022
2022
Historique:
received:
01
10
2021
accepted:
09
05
2022
entrez:
1
7
2022
pubmed:
2
7
2022
medline:
2
7
2022
Statut:
epublish
Résumé
Diabetic peripheral neuropathy (DPN) is a major complication of diabetes mellitus. Tight glycaemic management focused on lowering haemoglobin A1C and increasing time in the target glucose range along with metabolic risk factor management form the cornerstone of DPN prevention. However, there is limited evidence supporting the efficacy of glycaemic and metabolic control in reducing the symptoms and complications of DPN, including pain once painful DPN develops. DPN treatments include pharmacological agents and non-pharmacological interventions such as foot care and lifestyle modifications. Pharmacological agents primarily address pain symptoms, which affect 25-35% of people with DPN. First-line agents include the anticonvulsants pregabalin and gabapentin, the serotonin-norepinephrine reuptake inhibitors duloxetine and venlafaxine, and secondary amine tricyclic antidepressants, including nortriptyline and desipramine. All agents have unique pharmacological, safety and clinical profiles, and agent selection should be guided by the presence of comorbidities, potential for adverse effects, drug interactions and costs. Even with the current treatment options, people are commonly prescribed less than the recommended dose of medications, leading to poor management of DPN symptoms and treatment discontinuation. By keeping up with the latest therapy algorithms and treatment options, healthcare professionals can improve the care for people with DPN.
Identifiants
pubmed: 35775075
doi: 10.7573/dic.2021-10-2
pii: dic-2021-10-2
pmc: PMC9205568
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Informations de copyright
Copyright © 2022 Gandhi M, Fargo E, Prasad-Reddy L, Mahoney KM, Isaacs D.
Déclaration de conflit d'intérêts
Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/05/dic.2021-10-2-COI.pdf
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