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Year : 2022  |  Volume : 1  |  Issue : 2  |  Page : 99-113

Approach to painful diabetic peripheral neuropathy

1 Department of Diabetology and Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India
2 Department of Podiatry, Chellaram Diabetes Institute, Pune, Maharashtra, India
3 Department of Anaesthesia and Pain Management, Chellaram Diabetes Institute, Pune, Maharashtra, India

Correspondence Address:
Ambika G Unnikrishnan
Department of Diabetology and Endocrinology, Chellaram Diabetes Institute, Lalani Quantum, NH-4, Bavdhan (Budruk), Pune - 411 021, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cdrp.cdrp_4_22

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Painful diabetic peripheral neuropathy (PDPN) is a commonly encountered problem by a physician and poses a major treatment challenge. Although poor glycemic control is considered to be a main cause for the development of peripheral neuropathy, the overall etiopathogenesis remains unclear and needs further research. There are various tools to assess the status of nerves, but PDPN being a subjective factor is often measured in terms of pain scores or pain scale looking at the intensity and the phenotype of pain. PDPN affects the individual's quality of life and daily living and often disturbs the sleep and mental health. The management of PDPN includes achieving good glycemic control, following foot care practices, including the use of appropriate footwear and treatment for pain relief. The treatment of choice varies from topical application to the pain relieving patches and use of drugs such as anticonvulsants, antidepressants, and opioids which have shown some beneficial effect. Interventional and regional anesthesia have also been tried for the treatment of PDPN. Surgical decompression has shown a favorable effect on pain relief. There are unmet needs in the therapeutic management of PDPN, as available drugs give acceptable pain relief in very few patients, and fear of side effects may limit full-dose treatment. Till date, no medicine is available to reverse neuropathy.

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