Effective Treatments Available
for Diagnosed Diabetic Neuropathy
Without a cure, Intensive glucose control
and pain management are the most effective treatments
for slowing disease progression and improving
quality of life.
Diabetic symmetrical distal neuropathy is a common
complication of diabetes mellitus. Patients with
diabetic neuropathy often experience related complications,
such as pain, ambulation difficulties, and risk
of amputation.
Proper recognition and awareness of the disease
patterns and risk factors for diabetic neuropathy
are vital in order for physicians to make an accurate
diagnosis and recommend appropriate treatment
options.
Ann Noelle Poncelet, MD, from the University
of California, San Francisco, United States, reviewed
the risk factors, presentation patterns, diagnosis
and treatment of diabetic polyneuropathy.
Patients with diabetic polyneuropathy typically
experience functional disabilities, such as impaired
gait and impaired fine finger movements, as well
as autonomic symptoms, including abnormal sweating,
heart rate abnormalities, impotence, and diarrhoea
or constipation.
Characteristic symptoms of neuropathic pain include
burning, shooting or lancinating pain, allodynia
pain, paresthesias pain and hyperaesthesia pain,
aching, cramping, and nocturnal exacerbation.
Early diagnosis of diabetic polyneuropathy is
crucial in order to prevent chronic ulcers, amputation
and other related complications.
Diagnosis is typically made from analyzing the
clinical history of the patients and testing for
distal symmetrical sensory and motor neuropathy.
Other available diagnostic tests include EMG/nerve
conduction studies and laboratory studies that
are used to exclude treatable causes of neuropathy.
Physicians should also be aware of signs of non-diabetic
neuropathy which can be treated. These include
neuropathy which develops prior to or early in
the course of the diabetes, neuropathy occurring
in controlled diabetes, asymmetrical involvement,
and significant proximal involvement or upper
extremity involvement.
Currently, the only proven therapy for diabetic
polyneuropathy is intensive glucose control. This
type of management has been shown to reduce the
incidence and slow the progression of the disease.
In addition, treatment for symptoms of neuropathic
pain can greatly improve the quality of life of
patients with diabetic polyneuropathy. Pain management
and podiatric care can aid in the prevention of
chronic ulcerations and relieve intense pain.
Dr. Poncelet emphasizes that "diabetic patients
need an annual neurologic and clinical evaluation
of the foot," as recommended by the American
Diabetes Association. Furthermore, she notes that
"there is no cure for diabetic neuropathy,
but it is treatable," particularly with early
diagnosis.
Geriatrics 2003;58:6:16-30.
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DID
YOU KNOW: Non-Diabetic Americans
Are Living Longer
80 years for women and 77 for men, and it is attributed
to proper eating habits, nutritional awareness,
better treatment of illnesses, advancement of
medical technologies and public health efforts.
In a report by the U.S. Department of Health and
Human Services (HHS), life expectancy for Americans
hit an all time high of 77.2 years in 2001, a
hike from the previous 77 in 2000. Women can now
expect to live 79.8 years while men can expect
74.4 years.
