James Cornelius Fernandez, Tripathi Shiva, Karampatou Kyriaki, Gladston Divya V, Pappachan Joseph M
Department of Endocrinology & Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, United Kingdom.
Department of Anaesthesia & Pain Management, Lancashire Teaching Hospitals NHS Trust, United Kingdom.
Sisli Etfal Hastan Tip Bul. 2022 Mar 28;56(1):1-20. doi: 10.14744/SEMB.2021.54670. eCollection 2022.
The rising prevalence of diabetes mellitus (DM) leads on to an increase in chronic diabetic complications. Diabetic peripheral neuropathies (DPNs) are common chronic complications of diabetes. Distal symmetric polyneuropathy is the most prevalent form. Most patients with DPN will remain pain-free; however, painful DPN (PDPN) occurs in 6-34% of all DM patients and is associated with reduced health-related-quality-of-life and substantial economic burden. Symptomatic treatment of PDPN and diabetic autonomic neuropathy is the key treatment goals. Using certain patient related characteristics, subjects with PDPN can be stratified and assigned targeted therapies to produce better pain outcomes. The aim of this review is to discuss the various pathogenetic mechanisms of DPN with special reference to the mechanisms leading to PDPN and the various pharmacological and non-pharmacological therapies available for its management. Recommended pharmacological therapies include anticonvulsants, antidepressants, opioid analgesics, and topical medications.
糖尿病（DM）患病率的上升导致慢性糖尿病并发症增多。糖尿病周围神经病变（DPN）是糖尿病常见的慢性并发症。远端对称性多发性神经病变是最常见的形式。大多数DPN患者不会出现疼痛；然而，疼痛性DPN（PDPN）在所有糖尿病患者中的发生率为6% - 34%，并与健康相关生活质量下降和巨大的经济负担相关。PDPN和糖尿病自主神经病变的对症治疗是关键治疗目标。利用某些与患者相关的特征，可对PDPN患者进行分层并给予靶向治疗，以取得更好的疼痛治疗效果。本综述的目的是讨论DPN的各种发病机制，特别提及导致PDPN的机制以及可用于其管理的各种药物和非药物治疗方法。推荐的药物治疗包括抗惊厥药、抗抑郁药、阿片类镇痛药和局部用药。
