Evidence-based guideline: Treatment of painful diabetic neuropathy [RETIRED]
Dartmouth–Hitchcock Medical Center · University of Michigan–Ann Arbor · +6 more institutions
Abstract
To develop a scientifically sound and clinically relevant evidence-based guideline for the treatment of painful diabetic neuropathy (PDN).
We performed a systematic review of the literature from 1960 to August 2008 and classified the studies according to the American Academy of Neurology classification of evidence scheme for a therapeutic article, and recommendations were linked to the strength of the evidence. The basic question asked was: "What is the efficacy of a given treatment (pharmacologic: anticonvulsants, antidepressants, opioids, others; and nonpharmacologic: electrical stimulation, magnetic field treatment, low-intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?" RESULTS AND RECOMMENDATIONS: Pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and oxycodone controlled-release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness, and few studies have sufficient information on treatment effects on function and QOL.
Citation impact
- FWCI
- 34.85
- Percentile
- 100%
- References
- 52
Authors
11- VBVera BrilCorresponding
Dartmouth–Hitchcock Medical Center, University of Michigan–Ann Arbor, University of Washington, Medical College of Wisconsin, University of Toronto, University of Maryland, Baltimore, University of Wisconsin–Madison, University Health Network
- JEJ. England
University of Wisconsin–Madison, University of Toronto, University of Washington, University of Maryland, Baltimore, University of Michigan–Ann Arbor, Medical College of Wisconsin, University Health Network, Dartmouth–Hitchcock Medical Center
- GMGary M. Franklin
University of Maryland, Baltimore, Medical College of Wisconsin, University of Michigan–Ann Arbor, University Health Network, Dartmouth–Hitchcock Medical Center, University of Wisconsin–Madison, University of Toronto, University of Washington
- MBMiroslav Bačkonja
Medical College of Wisconsin, University of Maryland, Baltimore, University of Toronto, Dartmouth–Hitchcock Medical Center, University of Wisconsin–Madison, University of Washington, University of Michigan–Ann Arbor, University Health Network
- JAJ. A. Cohen
University of Washington, University Health Network, Medical College of Wisconsin, University of Michigan–Ann Arbor, University of Wisconsin–Madison, University of Maryland, Baltimore, Dartmouth–Hitchcock Medical Center, University of Toronto
Topics & keywords
- Guideline
- Medicine
- Intensive care medicine
- Pathology
- Good health and well-being