Neurologists Issue New Guideline for Treating Neuropathy

A team of neurologists has issued a new set of recommendations for the treatment of diabetic neuropathy, including drugs and other treatments that have been found to be the most effective therapies for the condition.

Diabetic neuropathy is damage to nerves, created by inflammation brought on by high blood sugar levels. Side effects can include severe tingling and pain as nerves are slowly destroyed by inflammation. In some cases, loss of nerve sensitivity can endanger limbs as people with diabetes unknowingly injure their legs or feet, unable to feel pain or wounds.

The guideline, published in the April 11, 2011, online issue of Neurology, was developed under the auspices of the American Academy of Neurology, in collaboration with the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation.

The neurology panel did an extensive review of the best scientific studies to create the guideline and specific drug recommendations. The guideline says that the seizure drug pregabalin is effective in treating diabetic nerve pain and can improve quality of life. However, it notes that pregabalin may not be appropriate for all patients.

The guideline also found that several other treatments show some effectiveness: the seizure drugs gabapentin and valproate; antidepressants such as venlafaxine, duloxetine, and amitriptyline; and painkillers such as opioids and capsaicin. Researchers also concluded that transcutaneous electric nerve stimulation, a portable electric device used to stimulate nerves, may be effective in treating diabetic nerve pain.

“Diabetic nerve pain is treatable, and we now have clear guidelines for this disabling condition. Many patients with diabetic neuropathy are receiving inadequate treatment or no treatment at all. This is a significant problem as the number of people with diabetes increases across the United States,” says guideline author James Russell, MD, professor of neurology, anatomy, and neurobiology at the University of Maryland School of Medicine. “Diabetic neuropathy is a painful and life-altering condition, so we need to find ways to help people who are suffering with it. These new recommendations provide physicians and patients the latest information, based on sound clinical research, so they can make the best decisions about their care.

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