Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic methodology or meta-analysis
PubMed 29709457 · doi:10.1016/j.clinthera.2018.04.001
What was done
The authors conducted a comprehensive narrative literature review across electronic databases (EMBASE, PubMed, OVID) and reference lists to evaluate the epidemiology, diagnostic approaches, surrogate endpoints, and pharmacotherapy for diabetic peripheral neuropathy (DPN), focusing on neuropathic pain management.
What was found
The review reports that DPN affects approximately half of patients with diabetes and has no licensed pathogenetic disease-modifying treatment other than glycemic control. Duloxetine and pregabalin are consistently recommended as first-line therapies for neuropathic pain across five major clinical guidelines (AACE, AAN, EFNS, NICE, ADA) and are FDA-approved. The abstract provides no primary statistical data or effect sizes.
Why it matters
It synthesizes broad clinical consensus across international guidelines confirming duloxetine and pregabalin as standard first-line therapies for painful DPN, while highlighting the ongoing lack of disease-modifying pharmacotherapies.
Limits
As a narrative review, it lacks systematic search criteria, quality appraisal, and meta-analytic synthesis. The abstract reports no included study counts, sample sizes, or quantitative outcome measures.
Cited by
- supports Pregabalin was approved by the FDA for the treatment of diabetic neuropathy pain.