NEUROPATHY IN DIABETIC MELLITUS: CAUSES, DIAGNOSIS AND THERAPEUTIC MODELS

Abstract

Diabetic neuropathy (DN) is the most common and severe side effect of diabetes mellitus, associated with high morbidity and mortality rates, significantly straining diabetes care. Modern definitions describe diabetic neuropathy as a symmetric, length-dependent sensory polyneuropathy resulting from metabolic changes and microvascular damage due to prolonged hyperglycemia and cardiovascular risk factors. The management and clinical assessment of DN are complex. Patients with DN should be evaluated for autonomic neuropathy, as these conditions often coexist. Currently, duloxetine and pregabalin are the primary medications prescribed for neuropathic pain, yet neither offers complete relief, even when combined. This study reviews the available treatments and current guidelines for managing diabetic neuropathy, focusing on pain management and diabetic autonomic neuropathy. There remains a critical need to investigate medication combinations that may more effectively reduce or even reverse the progression of the disease while enhancing pain relief. Addressing these gaps could lead to improved outcomes for patients suffering from this debilitating condition.