Current and Future Strategies for the Management of Diabetic Neuropathy

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

Diabetic neuropathy is common, related to increased morbidity and mortality, and has no effective treatment at present. Interventions based on putative pathways thought to contribute to damage and repair of nerve fibres have yielded little success to date. Pain is a potentially debilitating manifestation of diabetic neuropathy and has many potential sites of origin and, hence, modulation. Its cause is unclear and it does not respond well to traditional pain therapies, proposed to mediate their benefits via multiple peripheral and central mechanisms. A better understanding of the mechanisms leading to nerve fibre degeneration and regeneration as well as pain has recently resulted in the development of a more targeted approach to the treatment of diabetic neuropathy. Thus, specific NMDA receptor antagonists and more specific neuronal serotonin and norepinephrine (noradrenaline) uptake inhibitors offer promise in the treatment of painful diabetic neuropathy. A number of treatments which include the aldose reductase inhibitors and neurotrophins have failed to reach the clinical arena. However, the antioxidant alpha-lipoic acid, as well as compounds which correct vascular dysfunction and hence neuropathy, such as ACE inhibitors and protein kinase C-β inhibitors, have demonstrated more success.

Original languageEnglish
Pages (from-to)389-400
Number of pages12
JournalTreatments in Endocrinology
Volume2
Issue number6
DOIs
Publication statusPublished - 2003
Externally publishedYes

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Diabetic Neuropathies
Nerve Fibers
Pain
Therapeutics
Thioctic Acid
Aldehyde Reductase
Nerve Degeneration
Nerve Regeneration
Protein C Inhibitor
Nerve Growth Factors
Protein Kinase Inhibitors
N-Methyl-D-Aspartate Receptors
Angiotensin-Converting Enzyme Inhibitors
Protein Kinase C
Blood Vessels
Antioxidants
Morbidity
Mortality
Serotonin and Noradrenaline Reuptake Inhibitors

ASJC Scopus subject areas

  • Endocrinology

Cite this

Current and Future Strategies for the Management of Diabetic Neuropathy. / Malik, Rayaz.

In: Treatments in Endocrinology, Vol. 2, No. 6, 2003, p. 389-400.

Research output: Contribution to journalReview article

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