Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jul;72(7):863-872.
doi: 10.1111/jphp.13241. Epub 2020 Feb 17.

Treatment of diabetic peripheral neuropathy: a review

Maher R Khdour  1
Affiliations
Review

Treatment of diabetic peripheral neuropathy: a review

Maher R Khdour. J Pharm Pharmacol. 2020 Jul.

Abstract

Objectives: This review surveys current pharmacotherapies available for the treatment of diabetic peripheral neuropathy (DPN), emphasising their mechanisms of action.

Methods: A comprehensive literature review focusing on the 'pharmacotherapy and treatment of diabetic peripheral neuropathy' was conducted. The Database of International Pharmaceutical Abstracts, EMBASE, PubMed, OVID, Scopus, Google and Google Scholar were searched, and reference lists of relevant articles were also included.

Key findings: Diabetic peripheral neuropathy is often inadequately treated, and the role of improving glycaemic control specifically in type-2 diabetes remains unclear. It is crucial to explore the mechanisms of action and effectiveness of available therapies. Major international clinical guidelines for the management of DPN recommend several symptomatic treatments. First-line therapies include tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and anticonvulsants that act on calcium channels. Other therapies include opioids and topical agents such as capsaicin and lidocaine. The objectives of this paper are to review current guidelines for the pharmacological management of DPN and to discuss research relevant to the further development of pharmacological recommendations for the treatment of diabetic neuropathy.

Summary: Diabetic neuropathy is a highly prevalent, disabling condition, the management of which is associated with significant costs. Evidence supports the use of specific anticonvulsants and antidepressants for pain management in patients with diabetic peripheral neuropathy. All current guidelines advise a personalised approach with a low-dose start that is tailored to the maximum response having the least side effects or adverse events.

Keywords: neuropathic pain; noradrenaline reuptake inhibitors; opioids; pregabalin; tricyclic antidepressants.

PubMed Disclaimer

References

    1. International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels: International Diabetes Federation, 2017.
    1. Albers JW, Pop-Busui R. Diabetic neuropathy: mechanisms, emerging treatments, and subtypes. Curr Neurol Neurosci Rep 2014; 14: 473.
    1. Singh R et al. Diabetic peripheral neuropathy: current perspective and future directions. Pharmacol Res 2014; 80: 21-35.
    1. Boulton AJ. Management of diabetic peripheral neuropathy. Clin Diabetes 2005; 23: 9-15.
    1. Sadosky A et al. Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy. J Diabetes Complications 2015; 29: 212-217.

MeSH terms