Diabetic peripheral neuropathy affects approximately 60-70% of diabetic patients and a total of 347 million people worldwide.1 This complication is not only associated with painful symptoms, but can also lead to significant consequences such as paresthesia, loss of sensation, ulcers, osteomyelitis, gangrene, foot deformities, and amputation. Common symptoms of diabetic peripheral neuropathy are listed in Table 1. Because the symptoms and complications of diabetic peripheral neuropathy can lead to a significant decrease in a patient’s quality of life, it is important to evaluate the effectiveness of the various treatment options available in the management of diabetic peripheral neuropathy.
Unfortunately, treating diabetic peripheral neuropathy can be challenging.1 Although there are several therapeutic options for managing peripheral neuropathy, adherence to treatment is often a concern due to the common side effects associated with these agents. Medications that have been evaluated in the treatment of peripheral neuropathy include antidepressants, anticonvulsants, topical agents, and opioids.
A recent systematic review conducted by Çakici et al analyzed 27 randomized controlled trials (RCTs) to determine the effectiveness of various pharmacological, non-pharmacological, and alternative treatment options used in the management of peripheral neuropathy.1 A total of 19 treatment regimens were assessed in patients with diabetes mellitus to evaluate both neuropathic pain and sensibility symptoms. Primary outcomes of the review included total symptom score (TSS), visual analog scale (VAS), neuropathic pain rating scale, neuropathic pain scale, pain threshold, and neuropathic rating scale. The main results of the meta-analysis are summarized in Table 2.
11/17/2016
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