Wherefore Art Thou, O Treatment for Diabetic Neuropathy?

Research output: Chapter in Book/Report/Conference proceedingConference contribution

21 Citations (Scopus)


As of March 2016, we continue to advocate the diagnosis of diabetic neuropathy using a simple foot examination or monofilament, which identifies only those with severe neuropathy and hence risk of foot ulceration. Given the fact that the 5-year mortality rate of diabetic patients with foot ulceration is worse than that of most common cancers, surely we should be identifying patients at an earlier stage of neuropathy to prevent its progression to a stage with such a high mortality? Of course, we lament that there is no licensed treatment for diabetic neuropathy. Who is to blame? As researchers and carers, we have a duty of care to our patients with diabetic neuropathy. So, we have to look forward not backwards, and move away from our firmly entrenched views on the design and conduct of clinical trials for diabetic neuropathy. Relevant organizations such as Neurodiab, the American Diabetes Association and the Peripheral Nerve Society have to acknowledge that they cannot continue to endorse a bankrupt strategy. The FDA needs an open and self-critical dialogue with these organizations, to give pharmaceutical companies at least a fighting chance to deliver effective new therapies for diabetic neuropathy.

Original languageEnglish
Title of host publicationControversies In Diabetic Neuropathy, 2016
PublisherAcademic Press Inc.
Number of pages31
ISBN (Print)9780128039151
Publication statusPublished - 2016

Publication series

NameInternational Review of Neurobiology
ISSN (Print)00747742



  • Clinical trial
  • Corneal
  • Diabetes
  • FDA
  • Neuropathy
  • Small fiber neuropathy
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience

Cite this

Malik, R. (2016). Wherefore Art Thou, O Treatment for Diabetic Neuropathy? In Controversies In Diabetic Neuropathy, 2016 (Vol. 127, pp. 287-317). (International Review of Neurobiology; Vol. 127). Academic Press Inc.. https://doi.org/10.1016/bs.irn.2016.03.008