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Painful Diabetic Neuropathy: Mechanisms to Management


Deepthi V Tatiraju , Varsha M Jadhav , Vilasrao Kadam , Varsha B Bagade , Priya J Karambelkar

Abstract

Diabetes is one of the major public health concerns the world is facing. Modern lifestyle, obesity and stress are major contributing factors to the increased incidence of diabetes all over the world. The morbidity and mortality of Diabetes is related to the development of many complications which include neuropathy, nephropathy and retinopathy, the most prominent being diabetic neuropathy. The reported prevalence of neuropathy in diabetic patients ranges from 5% to 80%.The combination of peripheral vascular disease and neuropathy leads to the most feared complication i.e. diabetic foot, which is the only leading cause of limb amputation. Diabetic neuropathy is defined as the peripheral, somatic, or autonomic nerve damage attributed to Diabetes Mellitus. Diabetes affects the peripheral nerve at various sites and can lead to mononeuropathy, polyneuropathy, plexopathy, and radiculopathy. Acute or chronic pain occurs in diabetic neuropathic patients seriously affecting the quality of their life. Overall approximately 10% of patients experience persistent pain. The pathogenesis of pain is mainly attributed to alteration in polyol pathway, increased oxidative stress, impaired fatty acid metabolism and release of inflammatory factors. Most of the treatment strategies aim at symptomatic treatment like achieving lesser blood glucose levels and reduction of pain and inflammation.Nowadays a lot of herbal agents have proven to be effective in reducing neuropathic pain and reducing blood glucose levels.These agents include Gamma linolenic acid, Capsaicin, Withaniasomnifera (ashwagandha),Ginkgo biloba and several other plant species. Also techniques like acupressure and reflexology provide relief from severe neuropathic pain.



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