Epidemiology, Public Health Burden, and Treatment of Diabetic Peripheral Neuropathic Pain: A Review

Barrett, Amy; Lucero, Melanie A.; Le, Trong Kim; Robinson, Rebecca; Dworkin, Robert H.; Chappell, Amy S.

doi:10.1111/j.1526-4637.2006.00179.x

Cited by 207 publications

(156 citation statements)

References 64 publications

(85 reference statements)

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…Peripheral neuropathy is a common complication of both type 1 and type 2 diabetes, occurring in up to 47% of patients (1). The most common painful neuropathy observed with diabetes is diabetic peripheral neuropathic pain (DPNP), a burning, tingling, or aching sensation that is worse at night, often disturbs sleep, and subsequently impairs daytime function (2)(3)(4).…”

mentioning

confidence: 99%

Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain

Simpson

Wlodarczyk

2016

Diabetes Care

View full text Add to dashboard Cite

OBJECTIVETo evaluate the efficacy and safety of transdermal buprenorphine in patients with diabetic peripheral neuropathic pain (DPNP). RESEARCH DESIGN AND METHODSThis multicenter, randomized, double-blind, placebo-controlled, parallel-group trial enrolled patients with type 1 or type 2 diabetes and stable glycemic control who had been experiencing moderate to severe DPNP for at least 6 months on maximal tolerated conventional therapy. Patients were randomly assigned to receive buprenorphine (5 mg/h) or placebo patches. The dose was titrated to effect to a maximum of 40 mg/h. Paracetamol was available as rescue analgesia. The severity of pain and other symptoms of DPNP were assessed daily in a patient diary and at clinic visits. RESULTSOne hundred eight-six patients were enrolled, with 93 randomized to either buprenorphine or placebo. A high proportion of patients did not complete the study (buprenorphine 37 of 93, placebo 24 of 93). The main reason for premature withdrawal in the buprenorphine group was adverse events commonly due to untreated nausea and/or vomiting. Among the per-protocol population, more patients in the buprenorphine group (86.3%) experienced a 30% reduction in average versus baseline pain at week 12 than those in the placebo group (56.6%, P < 0.001). A nonsignificant trend favored the buprenorphine group within the intention-to-treat analysis of the same end point (51.7% vs. 41.3%, P = 0.175). CONCLUSIONSTransdermal buprenorphine, when tolerated, is an effective therapy for DPNP and provides another option to manage this challenging painful condition. Nausea and constipation need to be managed proactively to optimize treatment outcomes.

show abstract

mentioning

confidence: 99%

Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain

Simpson

Wlodarczyk

2016

Diabetes Care

View full text Add to dashboard Cite

show abstract

“…Various underlying medical conditions such as chronic renal disease, cancer and diabetes mellitus are associated with vertebrate osteomyelitis [15]. Around half of diabetic patients lead to peripheral neuropathy that may increase the risk of unrecognized infections [16], That will reduces the body's healing process and helps to grow the persistently soft tissue infection and open wound. These conditions may enhance the risk of osteomyelitis in all patients of diabetes.…”

Section: Clinical Manifestationmentioning

confidence: 99%

Osteomyelitis: Identification and Management

Kumari¹

2016

MOJOR

View full text Add to dashboard Cite

ObjectiveOsteomyelitis is a severe inflammation within the bone, bone marrow and surrounding soft tissue, that develops secondary to infection with microbial organisms. The objective of this article is to present an over view regarding the identification and management of osteomyelitis. IntroductionOsteomyelitis is acute and chronic inflammatory process based upon the histopathological finding rather than duration of infection. Osteomyelitis occurring primarily in children and adolescents pathogenic micro-organism cause inflammation and infection of bone, which lead to osteomyelitis and signs appears after two weeks of infection (Figure 1) In chronic osteomyelitis necrotic bone is present and signs may not appear until six weeks of infection [1]. Osteomyelitis infection is based on open wound, haematogenous or direct bacterial inoculation inside bone [2]. Radio nuclides imagine have improved diagnostic accuracy and better orthopaedic techniques as well as use of some prophylactic regimens which help to minimize the risk of infection among osteomyelitis patient. EtiologyBacterial Staphylococcus is common infection which causes an acute and chronic haematogenous osteomyelitis. Different types of pathogens among children are Type A streptococcus, Streptococcus pneumonia, Kingella kingae and Type B streptococcal infection is mainly occur in infants [3]. Streptococcus aureus is the common pathogen in bone among adults. Progressively, methicillinresistant Staphylococcus aureus is separated from patients with osteomyelitis [4]. Other persistent cases may be caused by adjacent infection, Pseudomonas aeruginosa, Escherichia coli and Staphylococcus epidermidis. Other reported cases of osteomyelitis are mycobacterial infections and fungal, these are rare and usually found in patients with weakened of body immunity [5]. PathogenesisOsteomyelitis may be occurring direct inoculation of causative organism in bone. Normal bone is highly resistant to infection occur in case of injury, trauma, and existence of foreign bodies [6]. Causative organism streptococcus aureus adhere to bone and expressing receptors for bone matrix. An insignificant skin infection emerge the serious infection such as sub-acute and acute bacterial endocarditic [7]. In children and adults, osteomyelitis mainly involves metaphysis of long bone, femur, proximal radius and hummers [8,9]. Penetrating injury and surgical contamination are the most common causes of direct inoculation osteomyelitis. Patent with severe vascular diseases often lead to osteomyelitis. Clinical ManifestationOsteomyelitis of acute haematogenous results from bacterial growth of bone. Most of the Children are more prone to infection because of developing of meta-physeal regions of the long bones, rich in blood supply and more prone to slight trauma. Acute haematogenous osteomyelitis in children occur about one-half of all patients who are under five years [10]. Children usually came with the symptom of exist fever, irritability, local erythema, swelling in soft tissues and tenderness bo...

show abstract

“…Peripheral neuropathy is common in diabetes mellitus that is observed in 30 to 50% of the patients (1). The lack of sense is starting in the toes and progressing proximally is just glove and sock distribution.…”

Section: Introductionmentioning

confidence: 99%

“…The lack of sense is starting in the toes and progressing proximally is just glove and sock distribution. Approximately 10 to 20% of patients with diabetes have DPNP that worsens at night (1,2). Diabetic peripheral neuropathy is diagnosed with pain feeling in lower extremities in diabetic patients (3).…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Duloxetine Versus Nortriptyline in Patients with Diabetic Peripheral Neuropathic Pain: A Double Blind Randomized Controlled Trial

Zakerkish¹,

Amiri²,

Nasab³

et al. 2017

Iran Red Crescent Med J

View full text Add to dashboard Cite

Background: Diabetic peripheral neuropathic pain (DPNP) is a common type of diabetic neuropathy. Blood sugar control is the first step for management of DPNP and drug treatment may be prescribed for the pain relief. Objectives: This study assessed the efficacy and safety of duloxetine and nortriptyline in patients with DPNP. Methods: This double-blind randomized clinical trial was conducted in the diabetes clinic of Golestan Hospital (Ahvaz, Iran). Convenience sampling and simple random allocation were used in the study. 134 patients with DPNP were randomly divided into two groups (67 patients in each group). The duloxetine group received 30 to 60 mg/day and nortriptyline group received 25 to 75 mg/day for a period of 6 weeks. Pain assessment was conducted based on a Visual analogue scale (VAS) and drug side effects were assessed on a weekly basis. Results: The study showed that both groups had significant reduction in pain severity at the end of the study (P < 0.05). The proportion of patients achieving 50% reduction in pain severity was significantly greater in the duloxetine group than the nortriptyline group (P < 0.05). The treatment side effects observed in the two groups were not significantly different (P = 0.298). Conclusions: Monotherapy with duloxetine and nortriptyline is safe and effective in the management of patients with DPNP.

show abstract

Epidemiology, Public Health Burden, and Treatment of Diabetic Peripheral Neuropathic Pain: A Review

Cited by 207 publications

References 64 publications

Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain

Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain

Osteomyelitis: Identification and Management

Comparative Efficacy of Duloxetine Versus Nortriptyline in Patients with Diabetic Peripheral Neuropathic Pain: A Double Blind Randomized Controlled Trial

Contact Info

Product

Resources

About