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Diabetic neuropathy: new strategies for treatment
Author(s) -
Várkonyi Tamás,
Kempler Peter
Publication year - 2008
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2007.00741.x
Subject(s) - medicine , gabapentin , duloxetine , pregabalin , adverse effect , diabetic neuropathy , glycemic , etiology , diabetes mellitus , pharmacology , anesthesia , alternative medicine , endocrinology , pathology
Current therapeutic possibilities can be divided into two groups: the pathogenetically oriented and the symptomatic therapy. One of the most important component of etiology‐based treatment is the stabilization of glycemic control. Based on efficacy and safety data benfotiamine and alpha‐lipoic acid should be considered as first choices among pathogenetically oriented treatments of diabetic neuropathy. Promising data were published about the aldose reductase inhibitor ranirestat. The symptomatic effect of antiepileptic drugs in diabetic painful neuropathy (DPN) is originated from several possible pharmacological properties. Pregabalin and gabapentin have the highest efficacy and the lowest frequency of adverse events among these drugs. Antidepressants also extensively used for symptomatic treatment in DPN. In the last years several studies were published about the benefial effect of duloxetine. Most likely combination therapy will be frequently applied in the future for the treatment of DPN, the optimal choice could be to combine pathogenetically oriented and symptomatic treatment.