Practical Management of Patients With Painful Diabetic Neuropathy
- 1 July 2005
- journal article
- review article
- Published by SAGE Publications in The Diabetes Educator
- Vol. 31 (4), 523-540
- https://doi.org/10.1177/0145721705278800
Abstract
Purpose Painful diabetic neuropathy (PDN) has a significant impact on patients’ quality of life, affecting sleep, mood, mobility, ability to work, interpersonal relationships, overall self-worth, and independence. The purpose of this article is to provide diabetes educators with current and essential tools for PDN assessment and management. Methods Medline and CINAHL database searches identified publications on the assessment and treatment of PDN. Identified research was evaluated, and information pertinent to diabetes educators was summarized. Results Recent advancements in assessment of neuropathic pain include identifying characteristics that distinguish between neuropathic and nonneuropathic pain. In the absence of treatment, research demonstrates that nerve damage may progress while pain diminishes. Many disease-modifying and symptom-management treatment options are available. Conclusion Good glycemic control is the first priority for both prevention and management of PDN. However, even with good glycemic control, up to 20% of patients will develop PDN. PDN recognition and assessment are critical to optimize management. Although several treatment modalities are available, few patients obtain complete pain relief. Recent advances in understanding the mechanisms underlying neuropathic pain should lead to better treatment and patient outcomes. Combination therapy, including nonpharmacologic modalities, may be required. Research evaluating the efficacy of combination therapy is needed.Keywords
This publication has 62 references indexed in Scilit:
- Diabetic Neuropathy: An intensive reviewAmerican Journal of Health-System Pharmacy, 2004
- The Development and Validation of a Neuropathy- and Foot Ulcer-Specific Quality of Life InstrumentDiabetes Care, 2003
- The pathogenesis and management of painful diabetic neuropathy: a reviewDiabetic Medicine, 2003
- Epidemiology and Impact on Quality of Life of Postherpetic Neuralgia and Painful Diabetic NeuropathyThe Clinical Journal of Pain, 2002
- Therapeutic potential of PKC inhibitors in painful diabetic neuropathyExpert Opinion on Investigational Drugs, 2001
- Management of Painful Diabetic NeuropathyDrugs & Aging, 2001
- Painful diabetic polyneuropathy: epidemiology, pain description, and quality of lifeDiabetes Research and Clinical Practice, 2000
- Management of painful diabetic neuropathy. A treatment algorithmJournal of the American Podiatric Medical Association, 1997
- A Prospective Study of Painful Symptoms, Small‐fibre Function and Peripheral Vascular Disease in Chronic Painful Diabetic NeuropathyDiabetic Medicine, 1994
- The Prevalence of Symptomatic, Diabetic Neuropathy in an Insulin-treated PopulationDiabetes Care, 1985