A 52-year-old woman with disabling peripheral neuropathy: review of diabetic polyneuropathy.

Full Abstract

Ms Q is a 52-year-old woman who has had progressive polyneuropathy in the setting of diabetes for the past 8 years. Ms Q's major disability is that of increasingly severe neuropathic pain and cramps that have been poorly responsive to a variety of therapies, including gabapentin and topiramate. The diagnosis of and differential diagnosis for diabetic polyneuropathy are reviewed herein. In general, treatment options for diabetic polyneuropathy remain primarily symptomatic. Improving the metabolic profile through weight loss, exercise, and if necessary, medications may help slow neuropathy progression. Many medications are effective in reducing pain, and newly developed ones, such as pregabalin and duloxetine, while specifically marketed for diabetic neuropathy, are likely to be no better and are considerably more expensive than older ones. Alpha-lipoic acid appears to be effective as well.

Author information

Author/s: Rutkove, Seward B (SB);

Affiliation: Harvard Medical School, and Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, TCC-810, Boston, MA 02215, USA. srutkove(-atsign-)bidmc.harvard.edu

Journal and publication information

Publication Type: Case Reports; Clinical Conference; Journal Article

Journal: JAMA : the journal of the American Medical Association (JAMA), published in United States. (Language: eng)

Reference: 2009-Oct; vol 302 (issue 13) : pp 1451-8

Dates: Created 2009/10/07; Completed 2009/10/14;

PMID: 19738078, status: MEDLINE (last retrieval date: 10/14/2009, IMS Date: )

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