Painful peripheral neuropathy in diabetes mellitus
update on therapy
DOI:
https://doi.org/10.34024/rnc.2001.v9.8912Keywords:
Diabetes, pain, neuropathyAbstract
Diabetes mellitus is a chronic and highly prevalent disease, progressing to a variety of complications. Diabetic neuropathy is a group of such complex and heterogeneous condictions, leading to several clinical presentation of autonomic and peripheral disease. Within the complications of Diabetes mellitus in the peripheral nervous system, the distal polineuropathy, a painful condition, is due to vascular, inflammatory and biochemical alterations. Hyperglicemia promotes the overload of sorbitol and fructose (glucose derivates), leading to axonal demyelinization, consequent to low levels of mioinositol inside the neuron. The clinical approuch is based on the evaluation of the pain, through clinical and/or electromiographic tests. The pharmacological treatment is symptomatic, it does not revert nor it avoids the progression of the disease. There are several classes of drugs that can be used, either in isolation or in a rational association. As an example of such drugs, we can mention the tricyclic antidepressants, anticonvulsive drugs, anti arrythmic drugs, topic capsaicin, aldose reductase inhibitors, alpha-lipoin acid and neurotrophic factors, some of which undergoing experimental trials.
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