Current options and perspectives in the treatment of diabetic neuropathy

Tamás Várkonyi, Zsuzsanna Putz, Katalin Keresztes, Tímea Martos, Csaba Lengyel, Alin Stirban, György Jermendy, Peter Kempler

Research output: Contribution to journalArticle

25 Citations (Scopus)

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. Alphalipoic-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.

Original languageEnglish
Pages (from-to)4981-5007
Number of pages27
JournalCurrent pharmaceutical design
Volume19
Issue number27
DOIs
Publication statusPublished - Aug 15 2013

    Fingerprint

Keywords

  • Alpha-lipoic-acid
  • Benfotiamine
  • Diabetic neuropathy
  • Duloxetine
  • Gabapentin
  • Pregabalin

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery

Cite this