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.
Current Pharmaceutical Design
Title:Current Options and Perspectives in the Treatment of Diabetic Neuropathy
Volume: 19 Issue: 27
Author(s): Tamas Varkonyi, Zsuzsanna Putz, Katalin Keresztes, Timea Martos, Csaba Lengyel, Alin Stirban, Gyorgy Jermendy and Peter Kempler
Affiliation:
Keywords: Diabetic neuropathy, benfotiamine, alpha-lipoic-acid, gabapentin, pregabalin, duloxetine.
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.
Export Options
About this article
Cite this article as:
Varkonyi Tamas, Putz Zsuzsanna, Keresztes Katalin, Martos Timea, Lengyel Csaba, Stirban Alin, Jermendy Gyorgy and Kempler Peter, Current Options and Perspectives in the Treatment of Diabetic Neuropathy, Current Pharmaceutical Design 2013; 19 (27) . https://dx.doi.org/10.2174/13816128113199990310
DOI https://dx.doi.org/10.2174/13816128113199990310 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Current and Promising Therapies in Autosomal Recessive Ataxias
CNS & Neurological Disorders - Drug Targets Ophthalmological and Otological Manifestations in the Antiphospholipid Syndrome
Current Rheumatology Reviews Obesity and Arterial Compliance Alterations
Current Vascular Pharmacology Capsaicin and Its Analogues: Structure-Activity Relationship Study
Current Medicinal Chemistry The Pentacyclic Triterpenoids in Herbal Medicines and Their Pharmacological Activities in Diabetes and Diabetic Complications
Current Medicinal Chemistry Red Cell Glycolytic Enzyme Disorders Caused by Mutations: An Update
Cardiovascular & Hematological Disorders-Drug Targets Thiopurine Biotransformation and Pharmacological Effects: Contribution of Oxidative Stress
Current Drug Metabolism Mitochondria-Targeted Antioxidants as a Therapeutic Strategy for Protecting Endothelium in Cardiovascular Diseases
Current Medicinal Chemistry The Importance of NAD in Multiple Sclerosis
Current Pharmaceutical Design Pain Management in Hematological Patients with Major Organ Dysfunctions and Comorbid Illnesses
Cardiovascular & Hematological Agents in Medicinal Chemistry Long-term Potentiation at Spinal C-fiber Synapses: A Target for Pathological Pain
Current Pharmaceutical Design Epigenetic Modification in Neuropathic Pain
Current Pharmaceutical Design Nanowired Drug Delivery Across the Blood-Brain Barrier in Central Nervous System Injury and Repair
CNS & Neurological Disorders - Drug Targets Combination of Statin Plus Renin Angiotensin System Inhibition for the Prevention or the Treatment of Atherosclerotic Cardiovascular Disease
Current Pharmaceutical Design Hyperglycemia, Hypoglycemia and Dementia: Role of Mitochondria and Uncoupling Proteins
Current Molecular Medicine Targeting Transient Receptor Potential Channels in Cardiometabolic Diseases and Myocardial Ischemia Reperfusion Injury
Current Drug Targets 2015 Update of Erectile Dysfunction Management Following Radical Prostatectomy: From Basic Research to Clinical Management
Current Pharmaceutical Design Non-Ceruloplasmin Copper as a Stratification Biomarker of Alzheimer’s Disease Patients: How to Measure and Use It
Current Alzheimer Research The Impact of Type 2 Diabetes on Women’s Health and Well-being During Their Reproductive Years: A Mixed-methods Systematic Review
Current Diabetes Reviews Neuropathic Pain and Lung Delivery of Nanoparticulate Drugs: An Emerging Novel Therapeutic Strategy
CNS & Neurological Disorders - Drug Targets