Long-Term Outcomes in the Management of Painful Diabetic Neuropathy

Lauren, M.; Clark, Alexander J.; Gordon, Allan; Lynch, Mary; Morley-Forster, Pat; Nathan, Howard J.; Smyth, Catherine; Stitt, Larry; Toth, Cory; Ware, Mark A.; Moulin, Dwight E.

doi:10.1017/cjn.2016.429

Cited by 12 publications

(11 citation statements)

References 28 publications

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“…Recently, a database has been established to prospectively evaluate the clinical effectiveness of neuropathic pain management in Canadian tertiary care centers. 6,8 Utilizing these data, the objective of the current study is to specifically determine the real-world management of central neuropathic pain relative to peripheral neuropathic pain.…”

Section: Objectivementioning

confidence: 99%

Long-Term Outcomes in the Management of Central Neuropathic Pain Syndromes: A Prospective Observational Cohort Study

Staudt

Clark

Gordon

et al. 2018

Can. J. Neurol. Sci.

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Section: Objectivementioning

confidence: 99%

Long-Term Outcomes in the Management of Central Neuropathic Pain Syndromes: A Prospective Observational Cohort Study

Staudt

Clark

Gordon

et al. 2018

Can. J. Neurol. Sci.

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“…13 In the clinical setting, PDN often involves polypharmacy, which highlights the difficulty in obtaining pain relief with single medications. 14,15 This review focuses on the current management strategies for the treatment of PDN including pharmacological, neuromodulation, and alternative therapies.…”

Section: Introductionmentioning

confidence: 99%

Current Strategies for the Management of Painful Diabetic Neuropathy

Staudt

Prabhala

Sheldon

et al. 2020

J Diabetes Sci Technol

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The development of painful diabetic neuropathy (PDN) is a common complication of chronic diabetes that can be associated with significant disability and healthcare costs. Prompt symptom identification and aggressive glycemic control is essential in controlling the development of neuropathic complications; however, adequate pain relief remains challenging and there are considerable unmet needs in this patient population. Although guidelines have been established regarding the pharmacological management of PDN, pain control is inadequate or refractory in a high proportion of patients. Pharmacotherapy with anticonvulsants (pregabalin, gabapentin) and antidepressants (duloxetine) are common first-line agents. The use of oral opioids is associated with considerable morbidity and mortality and can also lead to opioid-induced hyperalgesia. Their use is therefore discouraged. There is an emerging role for neuromodulation treatment modalities including intrathecal drug delivery, spinal cord stimulation, and dorsal root ganglion stimulation. Furthermore, consideration of holistic alternative therapies such as yoga and acupuncture may augment a multidisciplinary treatment approach. This aim of this review is to focus on the current management strategies for the treatment of PDN, with a discussion of treatment rationale and practical considerations for their implementation.

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“…[9] Neuropathic pain is defined as a hypersensitivity to pain and spontaneous pain in association with damage to or a lesion of nerve system. [10] In describing neuropathic pain, patient uses word for both negative and positive sensation, burning, numb, tingling, searing or scalding, cold, crushing, shooting, and stabbing. [11] Various drugs are recommended for treatment of diabetic peripheral neuropathic pain (DPNP) which includes…”

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confidence: 99%

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Singh¹

2019

IJGP

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Introduction: Neuropathic pain is defined as a hypersensitivity to pain and spontaneous pain in involvement with damage to or a lesion of nervous system. Various drugs are recommended for treatment of diabetic peripheral neuropathic pain which includes norepinephrine and serotonin and reuptake inhibitors, namely duloxetine, α-2δ ligands, namely pregabalin and gabapentin, tricyclic antidepressants, and opioid derivatives. The present study was designed to compare the safety and efficacy of duloxetine and pregabalin in the patients with diabetic neuropathic pain. Materials and Methods: The study was a prospective, randomized, and double-blind study. The 100 patients were selected and divided into two groups, each group was having 50 patients. Group I was receiving 60 mg of duloxetine once daily (O.D) and Group II was receiving 150 mg of pregabalin O.D. for 12 weeks. The efficacy of the drugs in diabetic neuropathic patients was assessed using following parameters: Diabetic neuropathic 4 (DN4) pain questionnaire, C-reactive protein (CRP), visual analog scale (VAS), and vibration perception threshold (VPT). Results: In the present study, the patients obtained a better pain reduction in the group which was treated with pregabalin compared with duloxetine using VAS and DN4. However, there is no significant difference in VPT and CRP scores in both groups. Conclusion: Hence, the present study concluded that pregabalin therapy has better efficacy for reducing neuropathic pain than duloxetine.

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Long-Term Outcomes in the Management of Painful Diabetic Neuropathy

Abstract: Almost one-third of patients being managed for PDN in a tertiary care setting achieve meaningful improvements in pain and function in the long term. Polypharmacy including analgesic antidepressants and anticonvulsants were the mainstays of effective symptom management.

Cited by 12 publications

References 28 publications

Long-Term Outcomes in the Management of Central Neuropathic Pain Syndromes: A Prospective Observational Cohort Study

Long-Term Outcomes in the Management of Central Neuropathic Pain Syndromes: A Prospective Observational Cohort Study

Current Strategies for the Management of Painful Diabetic Neuropathy

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