Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus
Diabetic peripheral neuropathy is a common chronic complication of diabetes mellitus, significantly impairing well-being, quality of life and functioning of patients. The prevalence of diabetic peripheral neuropathy in the Russian Federation ranges from 0.1% to 67.2% in type 1 and from 0.1 to 42.4%...
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| Format: | Article |
| Language: | English |
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Endocrinology Research Centre
2019-10-01
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| Series: | Сахарный диабет |
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| Online Access: | https://www.dia-endojournals.ru/jour/article/view/9625 |
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| author | Gagik R. Galstyan Elena G. Starostina Nikolay N. Yakhno Irina V. Gurieva Maxim V. Churyukanov Igor A. Strokov Alla Y. Tokmakova Mikhail L. Kukushkin Anatoly I. Martynov Marina V. Shestakova |
| author_facet | Gagik R. Galstyan Elena G. Starostina Nikolay N. Yakhno Irina V. Gurieva Maxim V. Churyukanov Igor A. Strokov Alla Y. Tokmakova Mikhail L. Kukushkin Anatoly I. Martynov Marina V. Shestakova |
| author_sort | Gagik R. Galstyan |
| collection | DOAJ |
| description | Diabetic peripheral neuropathy is a common chronic complication of diabetes mellitus, significantly impairing well-being, quality of life and functioning of patients. The prevalence of diabetic peripheral neuropathy in the Russian Federation ranges from 0.1% to 67.2% in type 1 and from 0.1 to 42.4% in type 2 diabetes mellitus. However, based on the large-scale epidemiological studies, the true prevalence of diabetic peripheral neuropathy is much higher (50 to 70%), with its painful variant occurring in 16% to 30% of patients. Despite the fact that diabetic peripheral neuropathy remains the most common chronic complication of diabetes mellitus, its diagnosis and therapy leave much to be desired. To optimize diagnostic and treatment approaches to painful diabetic peripheral neuropathy, a group of experts representing the leading Russian professional medical associations has developed clinical guidelines for the diagnosis and rational therapy of patients with painful diabetic peripheral neuropathy. This document presents practical aspects of the clinical diagnosis of painful diabetic peripheral neuropathy and an algorithm for differential diagnosis of pain in the lower extremities in patients with diabetes mellitus. The use of symptomatic analgesics with central action, such as anticonvulsants, antidepressants and opioids, is based on the main aspects of neuropathic pain pathophysiology. The characteristics of each drug class are given, with consideration of evidence on their efficacy, tolerability, and the possibility of combination therapy. The data on the first, second, and third lines of agents is presented in accordance with several international clinical guidelines. The need for a tailored drug choice, taking into account the evidence-based data on their efficacy and safety, concomitant drug therapy, tolerability, cost and preferences of the patient, age of the patient and concomitant disorders, is emphasized. |
| format | Article |
| id | doaj-art-76e2ab4d47454399b866be305a0ecb21 |
| institution | OA Journals |
| issn | 2072-0351 2072-0378 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | Endocrinology Research Centre |
| record_format | Article |
| series | Сахарный диабет |
| spelling | doaj-art-76e2ab4d47454399b866be305a0ecb212025-08-20T01:57:08ZengEndocrinology Research CentreСахарный диабет2072-03512072-03782019-10-0122430532710.14341/DM96258761Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensusGagik R. Galstyan0Elena G. Starostina1Nikolay N. Yakhno2Irina V. Gurieva3Maxim V. Churyukanov4Igor A. Strokov5Alla Y. Tokmakova6Mikhail L. Kukushkin7Anatoly I. Martynov8Marina V. Shestakova9Endocrinology Research CentreMoscow Regional Research and Clinical InstituteI.M. Sechenov First Moscow State Medical UniversityRussian Medical Academy of Continuous Professional EducationI.M. Sechenov First Moscow State Medical UniversityI.M. Sechenov First Moscow State Medical UniversityEndocrinology Research CentreA.I. Evdokimov Moscow State Medical Stomatological UniversityA.I. Evdokimov Moscow State Medical Stomatological UniversityEndocrinology Research CentreDiabetic peripheral neuropathy is a common chronic complication of diabetes mellitus, significantly impairing well-being, quality of life and functioning of patients. The prevalence of diabetic peripheral neuropathy in the Russian Federation ranges from 0.1% to 67.2% in type 1 and from 0.1 to 42.4% in type 2 diabetes mellitus. However, based on the large-scale epidemiological studies, the true prevalence of diabetic peripheral neuropathy is much higher (50 to 70%), with its painful variant occurring in 16% to 30% of patients. Despite the fact that diabetic peripheral neuropathy remains the most common chronic complication of diabetes mellitus, its diagnosis and therapy leave much to be desired. To optimize diagnostic and treatment approaches to painful diabetic peripheral neuropathy, a group of experts representing the leading Russian professional medical associations has developed clinical guidelines for the diagnosis and rational therapy of patients with painful diabetic peripheral neuropathy. This document presents practical aspects of the clinical diagnosis of painful diabetic peripheral neuropathy and an algorithm for differential diagnosis of pain in the lower extremities in patients with diabetes mellitus. The use of symptomatic analgesics with central action, such as anticonvulsants, antidepressants and opioids, is based on the main aspects of neuropathic pain pathophysiology. The characteristics of each drug class are given, with consideration of evidence on their efficacy, tolerability, and the possibility of combination therapy. The data on the first, second, and third lines of agents is presented in accordance with several international clinical guidelines. The need for a tailored drug choice, taking into account the evidence-based data on their efficacy and safety, concomitant drug therapy, tolerability, cost and preferences of the patient, age of the patient and concomitant disorders, is emphasized.https://www.dia-endojournals.ru/jour/article/view/9625diabetes mellitusdiabetic peripheral neuropathypainful neuropathyneuropathic paindiagnosistreatment |
| spellingShingle | Gagik R. Galstyan Elena G. Starostina Nikolay N. Yakhno Irina V. Gurieva Maxim V. Churyukanov Igor A. Strokov Alla Y. Tokmakova Mikhail L. Kukushkin Anatoly I. Martynov Marina V. Shestakova Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus Сахарный диабет diabetes mellitus diabetic peripheral neuropathy painful neuropathy neuropathic pain diagnosis treatment |
| title | Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus |
| title_full | Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus |
| title_fullStr | Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus |
| title_full_unstemmed | Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus |
| title_short | Diagnosis and rational treatment of painful diabetic peripheral neuropathy: an interdisciplinary expert consensus |
| title_sort | diagnosis and rational treatment of painful diabetic peripheral neuropathy an interdisciplinary expert consensus |
| topic | diabetes mellitus diabetic peripheral neuropathy painful neuropathy neuropathic pain diagnosis treatment |
| url | https://www.dia-endojournals.ru/jour/article/view/9625 |
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