Interní Med. 2013; 15(11-12): 358-362

Treatment of diabetic neuropathy

prof.MUDr.Zdeněk Ambler, DrSc.

Neurologická klinika LF UK a FN v Plzni

The number of people with type 2 diabetes is rising rapidly worldwide. Neuropathy is the common complication of diabetes and it is associated

with a wide range of clinical manifestations. Distal symmetrical sensory or sensorimotor polyneuropathy is a most frequent type

and small fiber damage is thought to result in painful symptoms. Painful diabetic neuropathy is common and is associated with significant

reduction in quality of life. No current disease-modifying treatments have been shown definitively to reduce or reverse diabetic sensory

polyneuropathy. Modulators of α2-δ subunit of calcium channels (gabapentin and especially pregabalin), serotonin and norepinephrine

reuptake inhibitors (especially duloxetine) and tricyclic antidepresants are the recommended treatments of the first choice for painful

diabetic neuropathies. Among other options are opioids and tramadol (especially in combination with drugs of the first choice), alphalipoic

acid, and in localized pain with allodynia plasters with 5% lidocain or 8% capsaicin.

Keywords: diabetic neuropathy, painful diabetic neuropathy, gabapentin, pregabalin, duloxetine, tricyclic antidepresants

Published: December 1, 2013  Show citation