Recognition and management of diabetic neuropathy.
Pain and disability associated with diabetic neuropathy have economic, social, and emotional consequences. Because these complications impact patients during the prime of their lives, physicians should screen and manage patients at risk. Improvement in glycemic and lipid management, glycemic variability, and lifestyle interventions such as smoking cessation should limit disease progression. Patients who have symptomatic disease should be treated, targeting a 50% improvement in pain within 4 weeks. Physicians should also strive to improve function and comorbidities such as sleep disorders, depression, and anxiety. Patient education is critical for treatment adherence and prevention of serious complications. Consequences associated with diabetic neuropathy include nontraumatic amputations and silent ischemia; thus proper foot care and education regarding "warning signs" of silent ischemia are necessary.
Unger
Jeff
J
Chino Medical Group, Diabetes and Headache Intervention Center, Chino, CA 91710, USA. jungermd@aol.com
Cole
B Eliot
BE
D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007249:Inflammation; D008403:Mass Screening; D018384:Oxidative Stress; D011493:Protein Kinase C; D012307:Risk Factors
D011493:Protein Kinase C