Current options and perspectives in the treatment of diabetic neuropathy

T. Várkonyi, Zsuzsanna Putz, Katalin Keresztes, Tímea Martos, C. Lengyel, Alin Stirban, G. Jermendy, P. 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 - 2013

Fingerprint

Diabetic Neuropathies
Therapeutics
Transketolase
Hexosamines
Advanced Glycosylation End Products
Pharmaceutical Preparations
Anticonvulsants
Protein Kinase C
Antidepressive Agents
Diabetes Mellitus
Antioxidants
Acids

Keywords

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

ASJC Scopus subject areas

  • Drug Discovery
  • Pharmacology

Cite this

Current options and perspectives in the treatment of diabetic neuropathy. / Várkonyi, T.; Putz, Zsuzsanna; Keresztes, Katalin; Martos, Tímea; Lengyel, C.; Stirban, Alin; Jermendy, G.; Kempler, P.

In: Current Pharmaceutical Design, Vol. 19, No. 27, 2013, p. 4981-5007.

Research output: Contribution to journalArticle

Várkonyi, T. ; Putz, Zsuzsanna ; Keresztes, Katalin ; Martos, Tímea ; Lengyel, C. ; Stirban, Alin ; Jermendy, G. ; Kempler, P. / Current options and perspectives in the treatment of diabetic neuropathy. In: Current Pharmaceutical Design. 2013 ; Vol. 19, No. 27. pp. 4981-5007.
@article{ae5eaf05ef154ffdab0fd9f29b541412,
title = "Current options and perspectives in the treatment of diabetic neuropathy",
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.",
keywords = "Alpha-lipoic-acid, Benfotiamine, Diabetic neuropathy, Duloxetine, Gabapentin, Pregabalin",
author = "T. V{\'a}rkonyi and Zsuzsanna Putz and Katalin Keresztes and T{\'i}mea Martos and C. Lengyel and Alin Stirban and G. Jermendy and P. Kempler",
year = "2013",
doi = "10.2174/13816128113199990310",
language = "English",
volume = "19",
pages = "4981--5007",
journal = "Current Pharmaceutical Design",
issn = "1381-6128",
publisher = "Bentham Science Publishers B.V.",
number = "27",

}

TY - JOUR

T1 - Current options and perspectives in the treatment of diabetic neuropathy

AU - Várkonyi, T.

AU - Putz, Zsuzsanna

AU - Keresztes, Katalin

AU - Martos, Tímea

AU - Lengyel, C.

AU - Stirban, Alin

AU - Jermendy, G.

AU - Kempler, P.

PY - 2013

Y1 - 2013

N2 - 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.

AB - 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.

KW - Alpha-lipoic-acid

KW - Benfotiamine

KW - Diabetic neuropathy

KW - Duloxetine

KW - Gabapentin

KW - Pregabalin

UR - http://www.scopus.com/inward/record.url?scp=84881329001&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881329001&partnerID=8YFLogxK

U2 - 10.2174/13816128113199990310

DO - 10.2174/13816128113199990310

M3 - Article

VL - 19

SP - 4981

EP - 5007

JO - Current Pharmaceutical Design

JF - Current Pharmaceutical Design

SN - 1381-6128

IS - 27

ER -