Management should encompass cornerstones of lifestyle modification, pathogenetically oriented treatment, treatment of neuropathic pain

TUESDAY, Dec. 5, 2023 (HealthDay News) -- For patients with diabetic sensorimotor polyneuropathy (DSPN), recommendations have been developed for diagnosis and treatment, according to an article published April 2022 in Diabetes Research and Clinical Practice.

Noting that DSPN is inadequately diagnosed and treated, Dan Ziegler, M.D., from the Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf in Germany, and colleagues developed recommendations for the screening, diagnosis, and treatment of DSPN in clinical practice.

To encourage adoption into clinical practice, guidelines should be clearer on diagnostic procedures, adequate treatment choices, dosing, and follow-up. The authors note that neuropathic symptoms and signs (deficits) underlie the clinical diagnosis of DSPN, with typical neuropathic symptoms including pain, paresthesia, and numbness, especially in the feet and calves. Three cornerstones are crucial for management of DSPN: lifestyle modification, including optimal diabetes treatment aimed at near-normoglycemia and multifactorial cardiovascular risk intervention; pathogenetically oriented pharmacotherapy (e.g., alpha-lipolic acid and benfotiamine); and treatment of the symptoms of neuropathic pain, such as analgesic pharmacotherapy and nonpharmacological options. Pain management should consider the individual risk profile and allow for improvement in quality of sleep, functionality, and general quality of life, as well as pain relief.

“To reduce the burden resulting from DSPN and its sequela, adequate consideration and implementation of strategies aimed at early detection and prevention of the condition in national diabetes plans is imperative,” the authors write.

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