Advances in the management of diabetic neuropathy

The authors review current advances in the therapy of diabetic neuropathy. The role of glycaemic control and management of cardiovascular risk factors in the prevention and treatment of neuropathic complications are discussed. As further options of pathogenetic ally oriented treatment, recent knowle...

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Bibliographic Details
Main Authors: Várkonyi Tamás
Körei Anna Erzsébet
Putz Zsuzsanna
Martos Tímea
Keresztes Katalin
Lengyel Csaba Attila
Nyiraty Szabolcs
Stirban Alin
Jermendy György
Kempler Péter
Format: Article
Published: 2017
Series:MINERVA MEDICA 108 No. 5
doi:10.23736/S0026-4806.17.05257-0

mtmt:3230579
Online Access:http://publicatio.bibl.u-szeged.hu/16384
Description
Summary:The authors review current advances in the therapy of diabetic neuropathy. The role of glycaemic control and management of cardiovascular risk factors in the prevention and treatment of neuropathic complications are discussed. As further options of pathogenetic ally oriented treatment, recent knowledge on benfotiamine and alpha-lipoic acid is comprehensively reviewed. Alpha-lipoic acid is a powerful antioxidant and clinical trials have proven its efficacy in ameliorating neuropathic signs and symptoms. Benfotiamine acts via the activation of transketolase and thereby inhibits alternative pathways triggered by uncontrolled glucose influx in the cells comprising polyol, hexosamine, protein-kinase-C pathways and formation of advanced glycation end products. Beyond additional forms of causal treatment, choices of symptomatic treatment will be summarized. The latter is mostly represented by the anticonvulsive agents pregabalin and gabapentin as well as duloxetine widely acknowledged as antidepressant. Finally, non-pharmacological therapeutic alternatives are summarized. The authors conclude that combination therapy should be more often suggested to our patients; especially the combination of pathogenetic and symptomatic agents.
Physical Description:419-437
ISSN:0026-4806