Diagnosis and Treatment of Painful Diabetic Peripheral Neuropathy
Diabetic neuropathies are the most common chronic complications of diabetes, with an estimated lifetime prevalence exceeding 50% in people with diabetes. Among various forms of neuropathy, diabetic peripheral neuropathy (DPN) is the most common and has the strongest evidence base regarding therapeutic approaches. This American Diabetes Association clinical compendium summarizes the latest information about screening for, diagnosing, and treating painful DPN in routine clinical practice. It opens with an overview of the epidemiology of DPN, followed by a description of the pathophysiology of the disease and its often severely painful symptoms. The authors recommend a stepwise approach to effectively diagnose DPN and offer a novel perspective on the impact of social determinants of health on the development and management of DPN. They summarizes the latest guidance on effective therapies, including pharmacological oral and topical agents, nutraceutical products, and nonpharmacological therapies, including physical activity and dietary interventions, passive modalities, and energy or nerve stimulation techniques. Throughout the publication, the authors identify knowledge gaps that need to be addressed and advocate a personalized care approach to reduce the burden of painful DPN and optimize quality of life for individuals affected by it.