Treating diabetic peripheral neuropathic pain

Tammy J. Lindsay, Blake C. Rodgers, Vincent Savath, Kevin Hettinger

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Diabetic peripheral neuropathic pain affects the functionality, mood, and sleep patterns of approximately 10 to 20 percent of patients with diabetes mellitus. Treatment goals include restoring function and improving pain control. Patients can realistically expect a 30 to 50 percent reduction in discomfort with improved functionality. The main classes of agents used to treat diabetic peripheral neuropathic pain include tricyclic antidepressants, anticonvulsants, serotonin-norepinephrine reuptake inhibitors, opiates and opiate-like substances, and topical medications. Physicians should ask patients whether they have tried complementary and alternative medicine therapies for their pain. Only two medications are approved specifically for the treatment of diabetic peripheral neuropathic pain: pregabalin and duloxetine. However, evidence supports the use of other therapies, and unless there are contraindications, tricyclic antidepressants are the first-line treatment. Because patients often have multiple comorbidities, physicians must consider potential adverse effects and possible drug interactions before prescribing a medication.

Original languageEnglish
Pages (from-to)151-158
Number of pages8
JournalAmerican Family Physician
Volume82
Issue number2
StatePublished - 15 Jul 2010
Externally publishedYes

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