title: Choosing drugs for the treatment of diabetic neuropathy.
abstract: BACKGROUND
  Diabetic sensorimotor polyneuropathy (DSP) affects 50% of diabetes patients and is painful in about 26%. Although disease-modifying therapies are not available for DSP, symptomatic treatments for painful diabetic neuropathy (PDN) are effective.
  
  
  METHODS
  We performed a MEDLINE search on PubMed using the search terms: treatment diabetic neuropathy and treatment PDN. This review outlines the problem posed by DSP, the clinical presentation and the characterization of PDN. A discussion of disease-modifying interventions, including the benefits of strict glycemic control, is followed by a focus on interventions for PDN including antidepressants, anticonvulsants and other treatments.
  
  
  CONCLUSIONS
  Disease modification in DSP remains an unmet need in clinical medicine affecting a large percentage of the population with concomitant healthcare costs. Strict glycemic control and attention to potential risk factors such as hypertension, hyperlipidemia and obesity may minimize DSP. Many patients benefit from treatment of their painful symptoms with anticonvulsants or antidepressants, but all are associated with significant side effects that limit their usefulness. There is a need for treatments of PDN with fewer side effects and more effective pain relief.
authors.affiliation: University of Toronto, University Health Network, Toronto General Hospital, Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Department of Medicine , 200 Elizabeth St, Toronto, Ontario M5G 2C4 , Canada +1 416 340 3315 ; +1 416 340 4189 ; vera.bril@utoronto.ca.
authors.forename: Majed
authors.initials: M
authors.lastname: Alabdali
authors.forename: Mohammad
authors.initials: M
authors.lastname: Qrimli
authors.forename: Carolina
authors.initials: C
authors.lastname: Barnett
authors.forename: Alon
authors.initials: A
authors.lastname: Abraham
authors.forename: Ari
authors.initials: A
authors.lastname: Breiner
authors.forename: Hans D
authors.initials: HD
authors.lastname: Katzberg
authors.forename: Danah
authors.initials: D
authors.lastname: Aljaafari
authors.forename: Hana
authors.initials: H
authors.lastname: Albulaihe
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Perkins
authors.forename: Vera
authors.initials: V
authors.lastname: Bril
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy; D059408:Pain Management; D011115:Polyneuropathies / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D007004:Hypoglycemic Agents
keywords: diabetic neuropathy; drug; painful diabetic neuropathy; treatment