Search

Painful diabetic neuropathy is observed in almost half of patients with diabetes mellitus (DM) and is associated with a decrease in the quality of life, emotional disorders, sleep disorders. The achievement and maintenance of the normal level of glucose in the blood is the basis for the prevention and treatment of DM, but this often does not allow the patient from pain and other clinical manifestations of neuropathy. Drug diabetic neuropathy therapy methods are discussed, the results of randomized placebo controlled studies on the efficiency and side effects of various drugs are analyzed. It is noted that pregabalin and gabapenitin, as antidepressants duloxetin, venlafaxin and amitriptyline, are most effective as anti-epileptic agents. In our country, with painful diabetic neuropathy, the preparations of a-lipoic acid are widely used. Analyzed data on efficacy and complications of the use of transcutaneus electrical nerves stimulation and spinal cord stimulation with pain diabetic neuropathy refractory to drug therapy. It is noted that many patients with pain diabetic neuropathy have combined diseases, detection and effective treatment of which can lead to an improvement in the state of patients and reduce the manifestations of neuropathy.

AIMS: To determine the prevalence of painful diabetic neuropathy (PDN), to evaluate the composition and efficacy of pharmacotherapy and to develop a differential algorithm for symptomatic treatment of PDN. MATERIALS AND METHODS: 4494 outpatient subjects participated in this study. Severity of pain syndrome was assessed with DN4 question- naire (supplemented with NTSS-9 scale) and visual analogue scale (VAS). After initial examination, a pharmacological evaluation of treatment was performed. RESULTS: Based on our data, prevalence of diabetic neuropathy was estimated at 54%, with painful form reaching 6.4%. Median age was 57.2-12.1, duration of diabetes mellitus - 16.5-10.6 years. Type 1 / type 2 ratio equaled 32.4% : 67.6%, male/female - 29.7%: 70.3%. Median HbA1c level was 8.4?1.6%. Ratio of chronic/acute forms of neuropathy was 267 : 20. Pain severity (as measured by VAS) distribution was as following: 15.6% ? severe, 40.6% ? moderate, 12.3% - mild, and 31.3% ? no pain symptoms. We did not find PDN to be associated with any parameters but sensory deficit (NTSS-9 and NDS: r=0.4; p