Pharmacological and Nonpharmacological Treatments for Painful Diabetic Peripheral Neuropathy

• Published in: Diabetes & metabolism journal Vol. 47; no. 6; pp. 743 - 756
• Main Authors: Jang, Han Na, Oh, Tae Jung
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Diabetes Association 01.11.2023; 대한당뇨병학회
• Subjects: capsaicin; Capsaicin - therapeutic use; Diabetes Mellitus - drug therapy; diabetic neuropathies; Diabetic Neuropathies - complications; Diabetic Neuropathies - drug therapy; duloxetine hydrochloride; Duloxetine Hydrochloride - therapeutic use; Humans; Neuralgia - drug therapy; Neuralgia - etiology; pain; pregabalin; Quality of Life; Review; spinal cord stimulation; tapentadol; United States; 내과학; United States; Diabetic neuropathies; Pain; Capsaicin; Spinal cord stimulation; Duloxetine hydrochloride; Pregabalin; Tapentadol
• ISSN: 2233-6079; 2233-6087
• DOI: 10.4093/dmj.2023.0018

Diabetic peripheral neuropathy (DPN) is one of the most prevalent chronic complications of diabetes. The lifetime prevalence of DPN is thought to be >50%, and 15%-25% of patients with diabetes experience neuropathic pain, referred to as "painful DPN." Appropriate treatment of painful DPN is important because this pain contributes to a poor quality of life by causing sleep disturbance, anxiety, and depression. The basic principle for the management of painful DPN is to control hyperglycemia and other modifiable risk factors, but these may be insufficient for preventing or improving DPN. Because there is no promising diseasemodifying medication for DPN, the pain itself needs to be managed when treating painful DPN. Drugs for neuropathic pain, such as gabapentinoids, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, alpha-lipoic acid, sodium channel blockers, and topical capsaicin, are used for the management of painful DPN. The U.S. Food and Drug Administration (FDA) has approved pregabalin, duloxetine, tapentadol, and the 8% capsaicin patch as drugs for the treatment of painful DPN. Recently, spinal cord stimulation using electrical stimulation is approved by the FDA for the treatment for painful DPN. This review describes the currently available pharmacological and nonpharmacological treatments for painful DPN.