Current Options and Perspectives in the Treatment of Diabetic Neuropathy

Author(s): Tamas Varkonyi, Zsuzsanna Putz, Katalin Keresztes, Timea Martos, Csaba Lengyel, Alin Stirban, Gyorgy Jermendy, Peter Kempler.

Journal Name: Current Pharmaceutical Design

Volume 19 , Issue 27 , 2013

Submit Manuscript
Submit Proposal

Abstract:

We aimed to summarise recent advances in the therapy of diabetic neuropathy. Although all therapeutic choices in the treatment of diabetes mellitus itself are based on clear pathophysiological basis, this approach is less present in the treatment of the “forgotten complication”, diabetic neuropathy. As part of pathogenetic oriented treatment, the role of glycemic control and cardiovascular risk factors are reviewed. The mode of action of benfotiamine is based on inhibition of key alternative pathways, including the polyol, hexosamine, protein-kinase-C pathways, and inhibition of advanced glycation end products formation, just as on activation of transketolase. Alpha- lipoic-acid is considered as the most potent antioxidant. Other forms of pathogenetic oriented treatment, including actovegin, will be summarised. The anticonvulsants gabapentin and pregabalin, as well as the antidepressant duloxetine represent the most important new drugs among agents for symptomatic relief. Most likely, we should offer combination treatment to our patients much more often, first of all combination of pathogenetic and symptomatic drugs. Finally, the broad spectrum of non-pharmacological treatment will be reviewed.

Keywords: Diabetic neuropathy, benfotiamine, alpha-lipoic-acid, gabapentin, pregabalin, duloxetine.

Rights & PermissionsPrintExport Cite as


Article Details

VOLUME: 19
ISSUE: 27
Year: 2013
Page: [4981 - 5007]
Pages: 27
DOI: 10.2174/13816128113199990310
Price: $58

Article Metrics

PDF: 31