New guidelines for diabetes pain

Reported by Susan Aldridge, PhD, medical journalist

Better management of diabetic peripheral neuropathic pain may result from the issue of new guidelines.
Almost half of all people with diabetes have some kind of neuropathy or nerve damage. Often, this is associated with pain which can be difficult to treat. However, there’s now hope for better outcomes, because the American Society of Pain Educators has issued the first comprehensive guidelines for the treatment of diabetic peripheral neuropathic pain (DPNP).

Analyzing clinical trials, the Society recommends two types of medication – first-tier and second-tier. The first-tier includes those few medications for which there is evidence of effect in DPNP. Examples are duloxetine, oxycodone controlled-release, pregabalin and all the tricyclic antidepressants. The second-tier includes those drugs which have a track record in relieving other types of nerve damage pain, but not specifically DPNP.

Till now, physicians have used a combination of antidepressants, anticonvulsants and various analgesics to relieve DPNP – not always with success. The new guidelines provide an evidence-based approach towards the problem. Given the expected increase in the incidence of diabetes and its associated problems, like DPNP, such guidelines are to be welcomed.

Source
Mayo Clinic Proceedings April 2006 Volume 81 No 4 (supplement S12-S25)

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