Diabetic Painful Neuropathy and Its Effective Medicinal Agents

In contemporary times, painful diabetic neuropathy is highly prevalent among the diabetic population. The primary cause of its neglect and lack of timely treatment lies in the medical staff's insufficient understanding of its pathogenesis. This study aims to discuss recently FDA-approved pharmacologic and nonpharmacologic treatment methods.

To conduct this study, keywords such as "Painful diabetic neuropathies," "Diabetes," "Anticonvulsant drugs," and "Pathological mechanisms" were used to search PubMed and Google Scholar databases. The search focused exclusively on clinical and pre-clinical studies related to painful diabetic neuropathy, with studies on other types of neuropathy excluded. Initially, 256 relevant articles were identified, and after eliminating duplications and irrelevant results, 66 studies were selected for the study's purpose.

Current disease management involves controlling blood sugar, addressing lifestyle-related risk factors, and managing the pathogenesis. Treatments that significantly reduce painful diabetic neuropathy primarily involve agents affecting ion channels. Recent research has shifted focus to mechanisms such as the polyol pathway, hexamine pathway, PKC, and oxidative stress to manage pain instead of the traditional approach based on ion channels.

Present agents like duloxetine and opioids exhibit limited efficacy and pose long-term side effects. While complementary and alternative treatments show effectiveness, they often encounter several limitations in clinical settings.