Diabetic peripheral neuropathy

Abstract

Diabetic neuropathy is one of the most common long-term complications of diabetes mellitus, affecting up to 50% of patients. Because hyperglycemia is one of the major risk factors associated with the development and progression of diabetic peripheral neuropathy (DPN), strict glycemic control is imperative. Controlling pain in patients with DPN can greatly improve their quality of life. Antidepressants and anticonvulsants are the medications most commonly used to treat DPN. Duloxetine and pregabalin are the only agents currently FDA-approved and indicated for pain associated with DPN. Pharmacists can educate patients on the essentials of good foot care, as well as discuss the importance of frequent foot examinations, proper glucose control, and smoking cessation. Diabetes mellitus is associated with significant morbidity and mortality, primarily owing to the development of chronic complications affecting major organ systems. Vascular complications are divided into microvascular (retinopathy, neuropathy, and nephropathy) and macrovascular complications (coronary heart disease, peripheral vascular disease, and cerebrovascular disease). The risk of complications increases with the duration and degree of hyperglycemia. Patients with type 2 diabetes mellitus (DM2) are often asymptomatic for a prolonged period before being diagnosed; therefore, many patients will have complications upon diagnosis.