New Guideline Examines Effective Treatments for Painful Diabetic Neuropathy

April 11, 2011

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The AAN has published a new guideline on the most effective treatments of painful diabetic neuropathy (PDN), the burning or tingling pain in the hands and feet that affects millions of people with diabetes. The guideline was published online ahead of print on April 11, 2011, and will appear in the May 17, 2011, print issue of Neurology®.

Read the guidelines and tools.

To help neurologists better understand the evidence-based guideline, an audio conference will be presented on Thursday, May 12, 2011, at 12:00 p.m. ET. The audio conference is only $25 for AAN members; $99 for the public; and free for students, residents, and fellows.

Visit www.aan.com/view/audiocon to get more information or to register.

PDN affects 16 percent of patients with diabetes, and it is frequently unreported and more frequently untreated. According to the guideline, the anticonvulsant pregabalin is effective in treating diabetic nerve pain and can improve quality of life, but the decision to prescribe should be made only on a case-by-case basis.

The guideline found that several other treatments are probably effective and should be considered, including the anticonvulsants gabapentin and valproate, antidepressants venlafaxine, duloxetine, and amitriptyline, and some opioids and topical pain medications such as capsaicin. Transcutaneous electric nerve stimulation (TENS), a widely used pain therapy involving a portable device, also was found to be probably effective for treating PDN.

"We were pleased to see that so many of these pain treatments had high-quality studies that support their use," said lead guideline author Vera Bril, MD, FRCP, with the University of Toronto. "Still, it is important that more research be done to show how well these treatments can be tolerated over time since PDN is a chronic condition that affects a person’s quality of life and ability to function."