Neurol. praxi, 2012; 13(Suppl.E)

Treatment of diabetic neuropathy

prof.MUDr.Josef Bednařík, CSc.¹, prof.MUDr.Zdeněk Ambler, DrSc.²

¹ Neurologická klinika LF MU a FN Brno

² Neurologická klinika LF UK a FN Plzeň

No current disease-modifying treatments have been shown definitively in randomized clinical trials to reduce or reverse diabetic sensory

polyneuropathy, but there are approaches to reduce the severity of diabetic neuropathy. Aggressive glycemic control is considered as

principal therapeutic measure to postpone development of neuropathy development and to slow its progression. The risk of neuropathy

development is also reduced by optimal management of modifiable cardiovascular risk factors and in prediabetes also by lifestyle interventions

leading to weight loss and increased physical activity. 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), alpha-lipoic acid, and in localized pain with allodynia plasters with 5 % mesocain or 8 % capsaicin.

Keywords: diabetic polyneuropathy, diabetic peripheral neuropathic pain, glycemic control

Published: March 1, 2013  Show citation