Title:Pharmacological Treatment of Diabetic Peripheral Neuropathy: An
Update
Volume: 21
Issue: 10
Author(s): Mohamed Rafiullah*Khalid Siddiqui
Affiliation:
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Keywords:
Diabetic peripheral neuropathy, diabetes, neuropathic pain, pharmacological treatment, diabetic complication, pain.
Abstract: Neuropathy is the most common complication of diabetes. 50% of adults with diabetes
will develop neuropathy in their lifetime. Diabetic peripheral neuropathy (DPN) is the major form
of neuropathy found in 75% of diabetic neuropathy incidences. Pharmacological treatments are recommended
for pain management in DPN. Anticonvulsants like pregabalin and gabapentin are the
preferred first-line treatment, followed by amitriptyline, duloxetine, and venlafaxine. Topical
agents like capsaicin and isosorbide dinitrate are also useful in treating the DPN and may be considered
for the second or third-line treatment. Opioids and related drugs are suggested for short-term
use during the acute exacerbation of pain. Combination therapy may be beneficial in patients who
do not respond to monotherapy. However, currently, there is no compelling evidence to suggest
any specific combination of agents. Disease-modifying agents such as alpha-lipoic acid and epalrestat
appear to improve the disease state but are not recommended by any guideline. This review discusses
the available pharmacological therapy for treating DPN. Also, we highlight the recommendations
from different guidelines about the pharmacological treatment of DPN.
