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4 . 2022

Diabetic sensorimotor polyneuropathy – a cholistic approach

Abstract

Diabetic sensorimotor polyneuropathy (DSMPN) manifests as widespread but underdiagnosed complication of diabetes and prediabetes, lead to chronic pain and foot ulcer and and reduces quality of life. A summary review of internationally agreed expert recommendations is presented and algorithms for screening, diagnosis and treatment of DSMPN in clinical practice are presented, compiled by the Delphic method of expert assessments set out in the international consensus on DSMPN published in 2021. The distinctive features of this document is a holistic approach that takes into account the need for timely screening, consistent diagnosis and comprehensive treatment. There are three key points in the treatment of DSMPN: lifestyle management, optimal treatment of diabetes mellitus, aimed at achieving a close to normoglycemic state, and the influence of modifying risk factors on the disease; pathogenetic treatment (for example, the use of alpha-lipoic (thioctic) acid and benfotiamine) and symptomatic treatment of pain in neuropathy, pharmacopreparations, and non-pharmacological methods of influence.The treatment of symptoms/pain should be personalized, identify the risks of progression of DSMPN, and will also improve the quality of life.

Keywords:diabetic polyneuropathy; neuropathic pain; Delphi method of expert assessments; screening; diagnosis; treatment; α-lipoic (thioctic) acid, benfotiamine; clinical guidelines

Funding. The study was supported by Wörwag Pharma.

Conflict of interest. Irina V. Gurieva has been consultant for Wörwag Pharma and has received honoraria from Wörwag Pharma, Meda, Takeda, Canon Pharma, Baush Health, Berlin Chemie and Pfizer.

For citation: Gurieva I.V. Diabetic sensorimotor polyneuropathy – a cholistic approach. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (4): 26–47. DOI: https://doi.org/10.33029/2304-9529-2022-11-4-26-47 (in Russian)

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All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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