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Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy

Tesfaye, Solomon, Selvarajah, Dinesh·2012·Diabetes/Metabolism Research and Reviews

Abstract

SUMMARY: Diabetic peripheral neuropathy (DPN) affects up to 50% of patients with diabetes and is a major cause of morbidity and increased mortality. Its clinical manifestations include painful neuropathic symptoms and insensitivity, which increases the risk for burns, injuries and foot ulceration. Several recent studies have implicated poor glycaemic control, duration of diabetes, hyperlipidaemia (particularly hypertryglyceridaemia), elevated albumin excretion rate s and obesity as risk factors for the development of DPN. Although there is now strong evidence for the importance of nerve microvascular disease in the pathogenesis of DPN, the risk factors for painful DPN are not known. However, emerging evidence regarding the central correlates of painful DPN is now afforded by brain imaging. The diagnosis of DPN begins with a careful history of sensory and motor symptoms. The quality and severity of neuropathic pain if present should be assessed using a suitable scale. Clinical examination should include inspection of the feet and evaluation of reflexes and sensory responses to vibration, light touch, pinprick and the 10‐g monofilament. Glycaemic control and addressing cardiovascular risk is now considered important in the overall management of the neuropathic patient. Pharmacological treatment of painful DPN includes tricyclic compounds, serotonin–norepinephrine reuptake inhibitors (e.g. duloxetine), anticonvulsants (e.g. pregabalin), opiates, membrane stabilizers, the antioxidant alpha lipoic acid and others. Over the past 7 years, new agents with perhaps less side effect profiles have immerged. Management of patients with painful neuropathy must be tailored to individual requirements and will depend on the presence of other co‐morbidities. There is limited literature with regard to combination treatment. Copyright © 2012 John Wiley & Sons, Ltd.

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Metadata

Authors
Tesfaye, S., & Selvarajah, D.
Venue
Diabetes/Metabolism Research and Reviews
Publisher
Wiley
Published
2012-01-23
Volume
28
Issue
S1
Pages
8-14
ISSN
  • 1520-7552 (ISSN-L)
  • 1520-7560
OpenAlex
W1537164314
Cited by
615
References
42
FWCI
23.78
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. https://app.cochat.ai/papers/10.1002/dmrr.2239
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Tesfaye, S., & Selvarajah, D. (2012). Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. Diabetes/Metabolism Research and Reviews. https://doi.org/10.1002/dmrr.2239

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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