Treatment of painful diabetic neuropathy

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Abstract

Painful diabetic neuropathy is observed in almost half of patients with diabetes mellitus (DM) and is associated with a decrease in the quality of life, emotional disorders, sleep disorders. The achievement and maintenance of the normal level of glucose in the blood is the basis for the prevention and treatment of DM, but this often does not allow the patient from pain and other clinical manifestations of neuropathy. Drug diabetic neuropathy therapy methods are discussed, the results of randomized placebo controlled studies on the efficiency and side effects of various drugs are analyzed. It is noted that pregabalin and gabapenitin, as antidepressants – duloxetin, venlafaxin and amitriptyline, are most effective as anti-epileptic agents. In our country, with painful diabetic neuropathy, the preparations of a-lipoic acid are widely used. Analyzed data on efficacy and complications of the use of transcutaneus electrical nerves stimulation and spinal cord stimulation with pain diabetic neuropathy refractory to drug therapy. It is noted that many patients with pain diabetic neuropathy have combined diseases, detection and effective treatment of which can lead to an improvement in the state of patients and reduce the manifestations of neuropathy.

About the authors

Vladimir A. Parfenov

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: vladimirparfenov@mail.ru
ORCID iD: 0000-0002-1992-7960

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Mariya V. Konyashova

Sechenov First Moscow State Medical University (Sechenov University)

Email: marusya-rygic@mail.ru
ORCID iD: 0000-0002-3667-7959

Graduate Student

Russian Federation, Moscow

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