Highlights & Basics
- Diabetic neuropathy (DN) in people with both type 1 and 2 diabetes is a complex consequence of hyperglycemia-induced alterations in multiple biochemical pathways. Other metabolic and vascular factors, particularly hypertriglyceridemia, are also important.
- The clinical presentation comprises a broad constellation of symptoms and deficits, involving sensory, motor, and autonomic nerve fibers, and multiple organ systems.
- Diabetic peripheral neuropathy is the most common chronic complication of diabetes, characterized by the presence of peripheral nerve dysfunction, diagnosed after the exclusion of other causes. Pain is the most troubling symptom for most patients, but many patients are completely asymptomatic.
- Treatment has traditionally focused on control of hyperglycemia as a means of slowing progression or delaying onset, on targeting potential pathogenetic mechanisms, and on pain reduction.
- Although pain is generated principally by peripheral nerve injury, there is recent evidence that the central nervous system may play a significant role in the disinhibition and amplification of pain. The most effective drugs in treating painful DN are centrally acting.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Progressive axonal loss in diabetic peripheral neuropathy
Plantar ulcer due to a coin in the shoe of a patient with an insensate foot
Vibratory testing
Light touch testing with monofilament
Plantar ulcer in a patient with type 1 diabetes
Nerve conduction testing of the lower leg
Charcot foot with ulcer in a patient with diabetes
Charcot foot in a patient with diabetes
Citations
Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017 Jan;40(1):136-54.[Abstract][Full Text]
Dyck PJ, Albers JW, Andersen H, et al; Toronto Expert Panel on Diabetic Neuropathy. Diabetic polyneuropathies: update on research definition, diagnostic criteria and estimation of severity. Diabetes Metab Res Rev. 2011 Oct;27(7):620-8.[Abstract][Full Text]
American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S1-321.[Full Text]
Price R, Smith D, Franklin G, et al. Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summary. Report of the AAN Guideline Subcommittee. Neurology. 2022 Jan 4;98(1):31-43.[Abstract][Full Text]
Senneville E, Albalawi Z, van Asten SA, et al. IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections. Clin Infect Dis. 2023 Oct 2:ciad527.[Abstract][Full Text]
1. Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017 Jan;40(1):136-54.[Abstract][Full Text]
2. Thomas PK. Classification, differential diagnosis, and staging of diabetic peripheral neuropathy. Diabetes. 1997 Sep;46 Suppl 2:S54-7.[Abstract]
3. Dyck PJ, Albers JW, Andersen H, et al; Toronto Expert Panel on Diabetic Neuropathy. Diabetic polyneuropathies: update on research definition, diagnostic criteria and estimation of severity. Diabetes Metab Res Rev. 2011 Oct;27(7):620-8.[Abstract][Full Text]
4. Vinik AI, Nevoret ML, Casellini C, et al. Diabetic neuropathy. Endocrinol Metab Clin North Am. 2013 Dec;42(4):747-87.[Abstract]
5. Young MJ, Boulton AJ, MacLeod AF, et al. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia. 1993 Feb;36(2):150-4.[Abstract]
6. Iqbal Z, Azmi S, Yadav R, et al. Diabetic peripheral neuropathy: epidemiology, diagnosis, and pharmacotherapy. Clin Ther. 2018 Apr 30;40(6):828-49.[Abstract][Full Text]
7. Sun J, Wang Y, Zhang X, et al. Prevalence of peripheral neuropathy in patients with diabetes: a systematic review and meta-analysis. Prim Care Diabetes. 2020 Oct;14(5):435-44.[Abstract]
8. Alam U, Asghar O, Petropoulos IN, et al. Small fiber neuropathy in patients with latent autoimmune diabetes in adults. Diabetes Care. 2015 Jul;38(7):e102-3.[Abstract][Full Text]
9. Nathan DM, Genuth S, Lachin J, et al; Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993 Sep 30;329(14):977-86.[Abstract][Full Text]
10. Albers JW, Herman WH, Pop-Busui R, et al; Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications Research Group. Effect of prior intensive insulin treatment during the Diabetes Control and Complications Trial (DCCT) on peripheral neuropathy in type 1 diabetes during the Epidemiology of Diabetes Interventions and Complications (EDIC) Study. Diabetes Care. 2010 May;33(5):1090-6.[Abstract][Full Text]
11. Pop-Busui R, Low PA, Waberski BH, et al; DCCT/EDIC Research Group. Effects of prior intensive insulin therapy on cardiac autonomic nervous system function in type 1 diabetes mellitus: the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study (DCCT/EDIC). Circulation. 2009 Jun 9;119(22):2886-93.[Abstract][Full Text]
12. Tesfaye S, Stevens LK, Stephenson JM, et al. Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study. Diabetologia. 1996 Nov;39(11):1377-84.[Abstract]
13. Maser RE, Steenkiste AR, Dorman JS, et al. Epidemiological correlates of diabetic neuropathy. Report from Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes. 1989 Nov;38(11):1456-61.[Abstract]
14. Pirart J, Lauvaux JP, Rey W. Blood sugar and diabetic complications. N Engl J Med. 1978 May 18;298(20):1149.[Abstract]
15. Dyck PJ, Kratz KM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology. 1993 Apr;43(4):817-24.[Abstract]
16. Sandbæk A, Griffin SJ, Sharp SJ, et al. Effect of early multifactorial therapy compared with routine care on microvascular outcomes at 5 years in people with screen-detected diabetes: a randomized controlled trial: the ADDITION-Europe study. Diabetes Care. 2014 Jul;37(7):2015-23.[Abstract][Full Text]
17. Charles M, Ejskjaer N, Witte DR, et al. Prevalence of neuropathy and peripheral arterial disease and the impact of treatment in people with screen-detected type 2 diabetes: the ADDITION-Denmark study. Diabetes Care. 2011 Oct;34(10):2244-9.[Abstract][Full Text]
18. Pop-Busui R, Lu J, Lopes N, et al; BARI 2D Investigators. Prevalence of diabetic peripheral neuropathy and relation to glycemic control therapies at baseline in the BARI 2D cohort. J Peripher Nerv Syst. 2009 Mar;14(1):1-13.[Abstract][Full Text]
19. Pop-Busui R, Lu J, Brooks MM, et al; BARI 2D Study Group. Impact of glycemic control strategies on the progression of diabetic peripheral neuropathy in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Cohort. Diabetes Care. 2013 Oct;36(10):3208-15.[Abstract][Full Text]
20. Pritchard N, Edwards K, Russell AW, et al. Corneal confocal microscopy predicts 4-year incident peripheral neuropathy in type 1 diabetes. Diabetes Care. 2015 Apr;38(4):671-5.[Abstract][Full Text]
21. Lovblom LE, Halpern EM, Wu T, et al. In vivo corneal confocal microscopy and prediction of future-incident neuropathy in type 1 diabetes: a preliminary longitudinal analysis. Can J Diabetes. 2015 Oct;39(5):390-7.[Abstract]
22. Gregg EW, Sorlie P, Paulose-Ram R, et al; 1999-2000 national health and nutrition examination survey. Prevalence of lower-extremity disease in the US adult population ≥40 years of age with and without diabetes: 1999-2000 National Health and Nutrition Examination Survey. Diabetes Care. 2004 Jul;27(7):1591-7.[Abstract][Full Text]
23. Spallone V, Ziegler D, Freeman R, et al; Toronto Consensus Panel on Diabetic Neuropathy. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management. Diabetes Metab Res Rev. 2011 Oct;27(7):639-53.[Abstract][Full Text]
24. Vileikyte L, Leventhal H, Gonzalez JS, et al. Diabetic peripheral neuropathy and depressive symptoms: the association revisited. Diabetes Care. 2005 Oct;28(10):2378-83.[Abstract][Full Text]
25. Vileikyte L, Rubin RR, Leventhal H. Psychological aspects of diabetic neuropathic foot complications: an overview. Diabetes Metab Res Rev. 2004 May-Jun;20 Suppl 1:S13-8.[Abstract]
26. Jaiswal M, Urbina EM, Wadwa RP, et al. Reduced heart rate variability among youth with type 1 diabetes: the SEARCH CVD study. Diabetes Care. 2013 Jan;36(1):157-62.[Abstract][Full Text]
27. Jaiswal M, Divers J, Dabelea D, et al. Prevalence of and risk factors for diabetic peripheral neuropathy in youth with type 1 and type 2 diabetes: SEARCH for Diabetes in Youth study. Diabetes Care. 2017 Sep;40(9):1226-32.[Abstract][Full Text]
28. Asghar O, Petropoulos IN, Alam U, et al. Corneal confocal microscopy detects neuropathy in subjects with impaired glucose tolerance. Diabetes Care. 2014 Sep;37(9):2643-6.[Abstract][Full Text]
29. Zilliox LA, Ruby SK, Singh S, et al. Clinical neuropathy scales in neuropathy associated with impaired glucose tolerance. J Diabetes Complications. 2015 Apr;29(3):372-7.[Abstract][Full Text]
30. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998 Sep 12;352(9131):837-53.[Abstract]
31. Pop-Busui R, Herman WH, Feldman EL, et al; DCCT/EDIC Research Group. DCCT and EDIC studies in type 1 diabetes: lessons for diabetic neuropathy regarding metabolic memory and natural history. Curr Diab Rep. 2010 Aug;10(4):276-82.[Abstract][Full Text]
32. Martin CL, Albers J, Herman WH, et al. Neuropathy among the diabetes control and complications trial cohort 8 years after trial completion. Diabetes Care. 2006 Feb;29(2):340-4.[Abstract][Full Text]
33. Ismail-Beigi F, Craven T, Banerji MA, et al; ACCORD trial group. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet. 2010 Aug 7;376(9739):419-30.[Abstract][Full Text]
34. Callaghan BC, Little AA, Feldman EL, et al. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012 Jun 13;(6):CD007543.[Abstract][Full Text]
35. Tesfaye S, Chaturvedi N, Eaton SE, et al; EURODIAB Prospective Complications Study Group. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005 Jan 27;352(4):341-50.[Abstract][Full Text]
36. Stratton IM, Cull CA, Adler AI, et al. Additive effects of glycaemia and blood pressure exposure on risk of complications in type 2 diabetes: a prospective observational study (UKPDS 75). Diabetologia. 2006 Aug;49(8):1761-9.[Abstract][Full Text]
37. Wiggin TD, Sullivan KA, Pop-Busui R, et al. Elevated triglycerides correlate with progression of diabetic neuropathy. Diabetes. 2009 Jul;58(7):1634-40.[Abstract][Full Text]
38. Dehghani C, Pritchard N, Edwards K, et al. Risk factors associated with corneal nerve alteration in type 1 diabetes in the absence of neuropathy: a longitudinal in vivo corneal confocal microscopy study. Cornea. 2016 Jun;35(6):847-52.[Abstract]
39. American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S1-321.[Full Text]
40. Pop-Busui R, Sima A, Stevens M. Diabetic neuropathy and oxidative stress. Diabetes Metab Res Rev. 2006 Jul-Aug;22(4):257-73.[Abstract]
41. Stevens MJ, Pop-Busui R, Greene DA, et al. Pathogenesis of diabetic neuropathy. In: Porte DJ, Sherwin R, Rifkin H, eds. Ellenberg and Rifkin's diabetes mellitus. Stamford, CT: Appleton and Lange; 2002.
42. Vincent AM, Russell JW, Low P, et al. Oxidative stress in the pathogenesis of diabetic neuropathy. Endocr Rev. 2004 Aug;25(4):612-28.[Abstract]
43. Sullivan KA, Feldman EL. New developments in diabetic neuropathy. Curr Opin Neurol. 2005 Oct;18(5):586-90.[Abstract]
44. Rosenson RS, Fioretto P, Dodson PM. Does microvascular disease predict macrovascular events in type 2 diabetes? Atherosclerosis. 2011 Sep;218(1):13-8.[Abstract]
45. Kazamel M, Dyck PJ. Sensory manifestations of diabetic neuropathies: anatomical and clinical correlations. Prosthet Orthot Int. 2015 Feb;39(1):7-16.[Abstract][Full Text]
46. Laverdet B, Danigo A, Girard D, et al. Skin innervation: important roles during normal and pathological cutaneous repair. Histol Histopathol. 2015 Aug;30(8):875-92.[Abstract]
47. Dehghani C, Russell AW, Perkins BA, et al. A rapid decline in corneal small fibers and occurrence of foot ulceration and Charcot foot. J Diabetes Complications. 2016 Nov - Dec;30(8):1437-9.[Abstract][Full Text]
48. Aikaeli F, Njim T, Gissing S, et al. Prevalence of microvascular and macrovascular complications of diabetes in newly diagnosed type 2 diabetes in low-and-middle-income countries: a systematic review and meta-analysis. PLOS Global Public Health. 2022 Jun 15;2(6): e0000599.[Full Text]
49. Cheng YJ, Gregg EW, Kahn HS, et al. Peripheral insensate neuropathy - a tall problem for US adults? Am J Epidemiol. 2006 Nov 1;164(9):873-80.[Abstract]
50. Kote GS, Bhat AN, Thajuddeen K, et al. Peripheral insensate neuropathy - is height a risk factor? J Clin Diagn Res. 2013 Feb;7(2):296-301.[Abstract][Full Text]
51. Tseng CH. Prevalence of lower-extremity amputation among patients with diabetes mellitus: is height a factor? CMAJ. 2006 Jan 31;174(3):319-23.[Abstract][Full Text]
52. Davis TM, Yeap BB, Davis WA, et al. Lipid-lowering therapy and peripheral sensory neuropathy in type 2 diabetes: the Fremantle Diabetes Study. Diabetologia. 2008 Apr;51(4):562-6.[Abstract][Full Text]
53. Andersen ST, Witte DR, Dalsgaard EM, et al. Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years: ADDITION-Denmark. Diabetes Care. 2018 Feb 27;41(5):1068-75.[Abstract][Full Text]
54. Duchen LW, Anjorin A, Watkins PJ, et al. Pathology of autonomic neuropathy in diabetes mellitus. Ann Intern Med. 1980 Feb;92(2 Pt 2):301-3.[Abstract]
55. Ejskjaer NT, Bradley JL, Buxton-Thomas MS, et al. Novel surgical treatment and gastric pathology in diabetic gastroparesis. Diabet Med. 1999 Jun;16(6):488-95.[Abstract]
56. Granberg V, Ejskjaer N, Peakman M, et al. Autoantibodies to autonomic nerves associated with cardiac and peripheral autonomic neuropathy. Diabetes Care. 2005 Aug;28(8):1959-64.[Abstract][Full Text]
57. Rabinowe SL, Brown FM, Watts M, et al. Complement-fixing antibodies to sympathetic and parasympathetic tissues in IDDM. Autonomic brake index and heart-rate variation. Diabetes Care. 1990 Oct;13(10):1084-8.[Abstract]
58. Stroud CR, Heller SR, Ward JD, et al. Analysis of antibodies against components of the autonomic nervous system in diabetes mellitus. QJM. 1997 Sep;90(9):577-85.[Abstract]
59. Ang L, Jaiswal M, Martin C, et al. Glucose control and diabetic neuropathy: lessons from recent large clinical trials. Curr Diab Rep. 2014;14(9):528.[Abstract][Full Text]
60. Aroda VR, Edelstein SL, Goldberg RB, et al; Diabetes Prevention Program Research Group. Long-term metformin use and vitamin B12 deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab. 2016 Apr;101(4):1754-61.[Abstract][Full Text]
61. Thurman DJ, Stevens JA, Rao JK; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: assessing patients in a neurology practice for risk of falls (an evidence-based review). 2008 Feb 5;70(6):473-9.[Abstract][Full Text]
62. Price R, Smith D, Franklin G, et al. Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summary. Report of the AAN Guideline Subcommittee. Neurology. 2022 Jan 4;98(1):31-43.[Abstract][Full Text]
63. Vinik AI, Maser RE, Mitchell BD, et al. Diabetic autonomic neuropathy. Diabetes Care. 2003 May;26(5):1553-79.[Abstract][Full Text]
64. Pop-Busui R. What do we know and we do not know about cardiovascular autonomic neuropathy in diabetes. J Cardiovasc Transl Res. 2012 Aug;5(4):463-78.[Abstract][Full Text]
65. Pop-Busui R. Cardiac autonomic neuropathy in diabetes: a clinical perspective. Diabetes Care. 2010 Feb;33(2):434-41.[Abstract][Full Text]
66. Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation. 2007 Jan 23;115(3):387-97.[Abstract][Full Text]
67. Smith DS, Ferris CD. Current concepts in diabetic gastroparesis. Drugs. 2003;63(13):1339-58.[Abstract]
68. Murray CD, Martin NM, Patterson M, et al. Ghrelin enhances gastric emptying in diabetic gastroparesis: a double blind, placebo controlled, crossover study. Gut. 2005 Dec;54(12):1693-8.[Abstract][Full Text]
69. Enzlin P, Mathieu C, Vanderschueren D, et al. Diabetes mellitus and female sexuality: a review of 25 years' research. Diabet Med. 1998 Oct;15(10):809-15.[Abstract]
70. Olsen SE, Bjørgaas MR, Åsvold BO, et al. Impaired awareness of hypoglycemia in adults with type 1 diabetes is not associated with autonomic dysfunction or peripheral neuropathy. Diabetes Care. 2016 Mar;39(3):426-33.[Abstract][Full Text]
71. Low PA, Benrud-Larson LM, Sletten DM, et al. Autonomic symptoms and diabetic neuropathy: a population-based study. Diabetes Care. 2004 Dec;27(12):2942-7.[Abstract][Full Text]
72. Zilliox L, Peltier AC, Wren PA, et al. Assessing autonomic dysfunction in early diabetic neuropathy: the Survey of Autonomic Symptoms. Neurology. 2011 Mar 22;76(12):1099-105.[Abstract][Full Text]
73. Revicki DA, Rentz AM, Dubois D, et al. Gastroparesis Cardinal Symptom Index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004 May;13(4):833-44.[Abstract]
74. Armstrong DG, Lavery LA, Vela SA, et al. Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration. Arch Intern Med. 1998 Feb 9;158(3):289-92.[Abstract][Full Text]
75. Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. Clin Neurol Neurosurg. 2006 Jul;108(5):477-81.[Abstract]
76. Spallone V. Update on the impact, diagnosis and management of cardiovascular autonomic neuropathy in diabetes: what is defined, what is new, and what is unmet. Diabetes Metab J. 2019 Feb;43(1):3-30.[Abstract][Full Text]
77. England JD, Gronseth GS, Franklin G, et al. Distal symmetric polyneuropathy: a definition for clinical research. Neurology. 2005 Jan 25;64(2):199-207.[Abstract][Full Text]
78. Lauria G, Hsieh ST, Johansson O, et al; European Federation of Neurological Societies; Peripheral Nerve Society. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. Eur J Neurol. 2010 Jul;17(7):903-12, e44-9.[Abstract][Full Text]
79. Chen X, Graham J, Dabbah MA, et al. Small nerve fiber quantification in the diagnosis of diabetic sensorimotor polyneuropathy: comparing corneal confocal microscopy with intraepidermal nerve fiber density. Diabetes Care. 2015 Jun;38(6):1138-44.[Abstract][Full Text]
80. Vas PR, Green AQ, Rayman G. Small fibre dysfunction, microvascular complications and glycaemic control in type 1 diabetes: a case-control study. Diabetologia. 2012 Mar;55(3):795-800.[Abstract][Full Text]
81. Shy ME, Frohman EM, So YT, et al. Quantitative sensory testing: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2003 Mar 25;60(6):898-904.[Abstract][Full Text]
82. Siao P, Cros DP. Quantitative sensory testing. Phys Med Rehabil Clin N Am. 2003 May;14(2):261-86.[Abstract]
83. Tavakoli M, Begum P, McLaughlin J, et al. Corneal confocal microscopy for the diagnosis of diabetic autonomic neuropathy. Muscle Nerve. 2015 Sep;52(3):363-70.[Abstract]
84. Bernardi L, Spallone V, Stevens M, et al; Toronto Consensus Panel on Diabetic Neuropathy. Methods of investigation for cardiac autonomic function in human research studies. Diabetes Metab Res Rev. 2011 Oct;27(7):654-64.[Abstract][Full Text]
85. Ziegler D, Zentai CP, Perz S, et al; KORA Study Group. Prediction of mortality using measures of cardiac autonomic dysfunction in the diabetic and nondiabetic population: the MONICA/KORA Augsburg Cohort Study. Diabetes Care. 2008 Mar;31(3):556-61.[Abstract][Full Text]
86. European Association of Urology. EAU guidelines on neuro-urology. Apr 2024 [internet publication].[Full Text]
87. Senneville E, Albalawi Z, van Asten SA, et al. IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections. Clin Infect Dis. 2023 Oct 2:ciad527.[Abstract][Full Text]
88. Lipsky BA, Peters EJ, Senneville E, et al. Expert opinion on the management of infections in the diabetic foot. Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:163-78.[Abstract][Full Text]
89. Mayaudon H, Miloche PO, Bauduceau B. A new simple method for assessing sudomotor function: relevance in type 2 diabetes. Diabetes Metab. 2010 Dec;36(6 Pt 1):450-4.[Abstract]
90. Asghar O, Arumugam P, Armstrong IS, et al. Individuals with impaired glucose tolerance demonstrate normal cardiac sympathetic innervation using I-123 mIBG scintigraphy. J Nucl Cardiol. 2015 Dec;22(6):1262-8.[Abstract]
91. Spallone V, Maiello MR, Morganti R, et al. Usefulness of ambulatory blood pressure monitoring in predicting the presence of autonomic neuropathy in type I diabetic patients. J Hum Hypertens. 2007 May;21(5):381-6.[Abstract]
92. Hamner JW, Taylor JA. Automated quantification of sympathetic beat-by-beat activity, independent of signal quality. J Appl Physiol. 2001 Sep;91(3):1199-206.[Abstract][Full Text]
93. Malik R, Veves A, Tesfaye S, et al; Toronto Consensus Panel on Diabetic Neuropathy. Small fiber neuropathy: role in the diagnosis of diabetic sensorimotor polyneuropathy. Diabetes Metab Res Rev. 2011 Oct;27(7):678-84.[Abstract][Full Text]
94. Kempler P, Amarenco G, Freeman R, et al; Toronto Consensus Panel on Diabetic Neuropathy. Management strategies for gastrointestinal, erectile, bladder, and sudomotor dysfunction in patients with diabetes. Diabetes Metab Res Rev. 2011 Oct;27(7):665-77.[Abstract][Full Text]
95. Boulton AJ, Malik RA, Arezzo JC, et al. Diabetic somatic neuropathies. Diabetes Care. 2004 Jun;27(6):1458-86.[Full Text]
96. Dyck PJ, Norell JE, Tritschler H, et al. Challenges in design of multicenter trials: end points assessed longitudinally for change and monotonicity. Diabetes Care. 2007 Oct;30(10):2619-25.[Abstract][Full Text]
97. Tavakoli M, Quattrini C, Abbott C, et al. Corneal confocal microscopy: a novel noninvasive test to diagnose and stratify the severity of human diabetic neuropathy. Diabetes Care. 2010 Aug;33(8):1792-7.[Abstract][Full Text]
98. Tavakoli M, Marshall A, Thompson L, et al. Corneal confocal microscopy: a novel noninvasive means to diagnose neuropathy in patients with Fabry disease. Muscle Nerve. 2009 Dec;40(6):976-84.[Abstract]
99. Mehra S, Tavakoli M, Kallinikos PA, et al. Corneal confocal microscopy detects early nerve regeneration after pancreas transplantation in patients with type 1 diabetes. Diabetes Care. 2007 Oct;30(10):2608-12.[Abstract][Full Text]
100. Gad H, Petropoulos IN, Khan A, et al. Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: a systematic review and meta-analysis. J Diabetes Investig. 2022 Jan;13(1):134-47.[Abstract][Full Text]
101. Pop-Busui R, Evans GW, Gerstein HC, et al; Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of cardiac autonomic dysfunction on mortality risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Care. 2010 Jul;33(7):1578-84.[Abstract][Full Text]
102. Ziegler D, Papanas N, Zhivov A, et al; German Diabetes Study (GDS) Group. Early detection of nerve fiber loss by corneal confocal microscopy and skin biopsy in recently diagnosed type 2 diabetes. Diabetes. 2014 Jul;63(7):2454-63.[Abstract][Full Text]
103. Feldman EL, Stevens MJ, Thomas PK, et al. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care. 1994 Nov;17(11):1281-9.[Abstract]
104. Young MJ, Adams JE, Anderson GF, et al. Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects. Diabetologia. 1993 Jul;36(7):615-21.[Abstract]
105. Cabezas-Cerrato J. The prevalence of clinical diabetic polyneuropathy in Spain: a study in primary care and hospital clinic groups. Neuropathy Spanish Study Group of the Spanish Diabetes Society (SDS). Diabetologia. 1998 Nov;41(11):1263-9.[Abstract]
106. Herman WH, Pop-Busui R, Braffett BH, et al; DCCT/EDIC Research Group. Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Diabet Med. 2012 Jul;29(7):937-44.[Abstract]
107. Diabetes Canada (Canadian Diabetes Association). Diabetes Canada (Canadian Diabetes Association). Clinical practice guidelines for the prevention and management of diabetes in Canada. 2018 [internet publication].[Full Text]
108. International Working Group on the Diabetic Foot. IWGDF practical guidelines on the prevention and management of diabetes-related foot disease. 2023 [internet publication].[Full Text]
109. National Institute for Health and Care Excellence. Diabetic foot problems: prevention and management. Oct 2019 [internet publication].[Full Text]
110. Diabetes Control and Complications Trial (DCCT) Research Group. Effect of intensive diabetes treatment on nerve conduction in the Diabetes Control and Complications Trial. Ann Neurol. 1995 Dec;38(6):869-80.[Abstract]
111. Martin CL, Albers JW, Pop-Busui R; DCCT/EDIC Research Group. Neuropathy and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes Care. 2014;37(1):31-8.[Abstract][Full Text]
112. Tang Y, Shah H, Bueno Junior CR, et al. Intensive risk factor management and cardiovascular autonomic neuropathy in type 2 diabetes: the ACCORD trial. Diabetes Care. 2021 Jan;44(1):164-73.[Abstract][Full Text]
113. Kennedy WR, Navarro X, Goetz FC, et al. Effects of pancreatic transplantation on diabetic neuropathy. N Engl J Med. 1990 Apr 12;322(15):1031-7.[Abstract][Full Text]
114. Navarro X, Sutherland DE, Kennedy WR. Long-term effects of pancreatic transplantation on diabetic neuropathy. Ann Neurol. 1997 Nov;42(5):727-36.[Abstract]
115. Tavakoli M, Mitu-Pretorian M, Petropoulos IN, et al. Corneal confocal microscopy detects early nerve regeneration in diabetic neuropathy after simultaneous pancreas and kidney transplantation. Diabetes. 2013 Jan;62(1):254-60.[Abstract][Full Text]
116. Oyibo SO, Prasad YD, Jackson NJ, et al. The relationship between blood glucose excursions and painful diabetic peripheral neuropathy: a pilot study. Diabet Med. 2002 Oct;19(10):870-3.[Abstract]
117. Bashir M, Elhadd T, Dabbous Z, et al. Optimal glycaemic and blood pressure but not lipid targets are related to a lower prevalence of diabetic microvascular complications. Diabetes Metab Syndr. 2021 Sep-Oct;15(5):102241.[Abstract]
118. Callaghan BC, Reynolds EL, Banerjee M, et al. Dietary weight loss in people with severe obesity stabilizes neuropathy and improves symptomatology. Obesity (Silver Spring). 2021 Dec;29(12):2108-18.[Abstract]
119. Look AHEAD Research Group. Effects of a long-term lifestyle modification programme on peripheral neuropathy in overweight or obese adults with type 2 diabetes: the Look AHEAD study. Diabetologia. 2017 Jun;60(6):980-8.[Abstract][Full Text]
120. Dorresteijn JA, Valk GD. Patient education for preventing diabetic foot ulceration. Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:101-6.[Abstract][Full Text]
121. Smith AG, Russell J, Feldman EL, et al. Lifestyle intervention for pre-diabetic neuropathy. Diabetes Care. 2006 Jun;29(6):1294-9.[Abstract][Full Text]
122. Kluding PM, Pasnoor M, Singh R, et al. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complications. 2012 Sep-Oct;26(5):424-9.[Abstract][Full Text]
123. Kristensen FPB, Sanchez-Lastra MA, Dalene KE, et al. Leisure-time physical activity and risk of microvascular complications in individuals with type 2 diabetes: a UK biobank study. Diabetes Care. 2023 Oct 1;46(10):1816-24.[Abstract][Full Text]
124. National Institute for Health and Care Excellence. Neuropathic pain in adults: pharmacological management in non-specialist settings. Sep 2020 [internet publication].[Full Text]
125. Finnerup NB, Attal N, Haroutounian S, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015 Feb;14(2):162-73.[Abstract][Full Text]
126. Derry S, Bell RF, Straube S, et al. Pregabalin for neuropathic pain in adults. Cochrane Database Syst Rev. 2019 Jan 23;(1):CD007076.[Abstract][Full Text]
127. Wiffen PJ, Derry S, Bell RF, et al. Gabapentin for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017 Jun 9;(6):CD007938.[Abstract][Full Text]
128. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014 Jan 3;(1):CD007115.[Abstract][Full Text]
129. Raskin J, Wang F, Pritchett YL, et al. Duloxetine for patients with diabetic peripheral neuropathic pain: a 6-month open-label safety study. Pain Med. 2006 Sep-Oct;7(5):373-85.[Abstract]
130. Quilici S, Chancellor J, Löthgren M, et al. Meta-analysis of duloxetine vs. pregabalin and gabapentin in the treatment of diabetic peripheral neuropathic pain. BMC Neurol. 2009 Feb 10;9:6.[Abstract][Full Text]
131. Irving G, Tanenberg RJ, Raskin J, et al. Comparative safety and tolerability of duloxetine vs. pregabalin vs. duloxetine plus gabapentin in patients with diabetic peripheral neuropathic pain. Int J Clin Pract. 2014 Sep;68(9):1130-40.[Abstract]
132. Gallagher HC, Gallagher RM, Butler M, et al. Venlafaxine for neuropathic pain in adults. Cochrane Database Syst Rev. 2015 Aug 23;(8):CD011091.[Abstract][Full Text]
133. Colvard MD. Key differences between venlafaxine XR and desvenlafaxine: an analysis of pharmacokinetic and clinical data. Mental Health Clin. 2014;4(1):35-9.[Full Text]
134. Allen R, Sharma U, Barlas S. Clinical experience with desvenlafaxine in treatment of pain associated with diabetic peripheral neuropathy. J Pain Res. 2014 Jun;7:339-51.[Abstract][Full Text]
135. Peltier A, Goutman SA, Callaghan BC. Painful diabetic neuropathy. BMJ. 2014 May 6;348:g1799.[Abstract]
136. Gillman PK. Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. Br J Pharmacol. 2007 Jul;151(6):737-48.[Abstract][Full Text]
137. Moore RA, Derry S, Aldington D, et al. Amitriptyline for neuropathic pain in adults. Cochrane Database Syst Rev. 2015 Jul 6;(7):CD008242.[Abstract][Full Text]
138. Derry S, Wiffen PJ, Aldington D, et al. Nortriptyline for neuropathic pain in adults. Cochrane Database Syst Rev. 2015 Jan 8;(1):CD011209.[Abstract][Full Text]
139. Hearn L, Derry S, Phillips T, et al. Imipramine for neuropathic pain in adults. Cochrane Database Syst Rev. 2014 May 19;(5):CD010769.[Abstract][Full Text]
140. Hearn L, Moore RA, Derry S, et al. Desipramine for neuropathic pain in adults. Cochrane Database Syst Rev. 2014 Sep 23;(9):CD011003.[Abstract][Full Text]
141. Richelson E. Pharmacology of antidepressants - characteristics of the ideal drug. Mayo Clin Proc. 1994 Nov;69(11):1069-81.[Abstract]
142. Gill D, Derry S, Wiffen PJ, et al. Valproic acid and sodium valproate for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2011 Oct 5;(10):CD009183.[Abstract][Full Text]
143. Sindrup SH, Gram LF, Brosen K, et al. The selective serotonin reuptake inhibitor paroxetine is effective in the treatment of diabetic neuropathy symptoms. Pain. 1990 Aug;42(2):135-44.[Abstract]
144. Max MB, Lynch SA, Muir J, et al. Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. N Engl J Med. 1992 May 7;326(19):1250-6.[Abstract]
145. Goodnick PJ, Jimenez I, Kumar A. Sertraline in diabetic neuropathy: preliminary results. Ann Clin Psychiatry. 1997 Dec;9(4):255-7.[Abstract]
146. Tesfaye S, Wilhelm S, Lledo A, et al. Duloxetine and pregabalin: high-dose monotherapy or their combination? The "COMBO-DN study" - a multinational, randomized, double-blind, parallel-group study in patients with diabetic peripheral neuropathic pain. Pain. 2013 Dec;154(12):2616-25.[Abstract]
147. Bouhassira D, Wilhelm S, Schacht A, et al. Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: data from the randomized, double-blind, COMBO-DN study. Pain. 2014 Oct;155(10):2171-9.[Abstract][Full Text]
148. Tesfaye S, Sloan G, Petrie J, et al. Comparison of amitriptyline supplemented with pregabalin, pregabalin supplemented with amitriptyline, and duloxetine supplemented with pregabalin for the treatment of diabetic peripheral neuropathic pain (OPTION-DM): a multicentre, double-blind, randomised crossover trial. Lancet. 2022 Aug 27;400(10353):680-90.[Abstract][Full Text]
149. Holbech JV, Bach FW, Finnerup NB, et al. Imipramine and pregabalin combination for painful polyneuropathy: a randomized controlled trial. Pain. 2015 May;156(5):958-66.[Abstract]
150. Gibbons CH, Wang N, Freeman R. Capsaicin induces degeneration of cutaneous autonomic nerve fibers. Ann Neurol. 2010 Dec;68(6):888-98.[Abstract][Full Text]
151. Derry S, Rice AS, Cole P, et al. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017 Jan 13;(1):CD007393.[Abstract][Full Text]
152. Agrawal RP, Goswami J, Jain S, et al. Management of diabetic neuropathy by sodium valproate and glyceryl trinitrate spray: a prospective double-blind randomized placebo-controlled study. Diabetes Res Clin Pract. 2009 Mar;83(3):371-8.[Abstract]
153. Barbano RL, Herrmann DN, Hart-Gouleau S, et al. Effectiveness, tolerability, and impact on quality of life of the 5% lidocaine patch in diabetic polyneuropathy. Arch Neurol. 2004 Jun;61(6):914-8.[Abstract][Full Text]
154. Dubinsky RM, Miyasaki J. Assessment: efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2010 Jan 12;74(2):173-6.[Abstract][Full Text]
155. Kumar D, Marshall HJ. Diabetic peripheral neuropathy: amelioration of pain with transcutaneous electrostimulation. Diabetes Care. 1997 Nov;20(11):1702-5.[Abstract]
156. Julka IS, Alvaro M, Kumar D. Beneficial effects of electrical stimulation on neuropathic symptoms in diabetes patients. J Foot Ankle Surg. 1998 May-Jun;37(3):191-4.[Abstract]
157. Abuaisha BB, Costanzi JB, Boulton AJ. Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study. Diabetes Res Clin Pract. 1998 Feb;39(2):115-21.[Abstract]
158. National Institute for Health and Care Excellence. Percutaneous electrical nerve stimulation for refractory neuropathic pain. Mar 2013 [internet publication].[Full Text]
159. de Vos CC, Meier K, Zaalberg PB, et al. Spinal cord stimulation in patients with painful diabetic neuropathy: a multicentre randomized clinical trial. Pain. 2014 Nov;155(11):2426-31.[Abstract]
160. Slangen R, Schaper NC, Faber CG, et al. Spinal cord stimulation and pain relief in painful diabetic peripheral neuropathy: a prospective two-center randomized controlled trial. Diabetes Care. 2014 Nov;37(11):3016-24.[Abstract][Full Text]
161. Duarte RV, Nevitt S, Maden M, et al. Spinal cord stimulation for the management of painful diabetic neuropathy: a systematic review and meta-analysis of individual patient and aggregate data. Pain. 2021 Nov 1;162(11):2635-43.[Abstract]
162. Duarte RV, Nevitt S, Copley S, et al. Systematic review and network meta-analysis of neurostimulation for painful diabetic neuropathy. Diabetes Care. 2022 Oct 1;45(10):2466-75.[Abstract][Full Text]
163. Albers JW, Pop-Busui R. Diabetic neuropathy: mechanisms, emerging treatments, and subtypes. Curr Neurol Neurosci Rep. 2014 Aug;14(8):473.[Abstract]
164. Gaede P, Lund-Andersen H, Parving HH, et al. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008 Feb 7;358(6):580-91.[Abstract][Full Text]
165. The effect of intensive diabetes therapy on measures of autonomic nervous system function in the Diabetes Control and Complications Trial (DCCT). Diabetologia. 1998 Apr;41(4):416-23.[Abstract]
166. MacLean AR, Allen EV. Orthostatic hypotension and orthostatic tachycardia: treatment with "head-up" bed. JAMA. 1940;115(25):2162-7.[Full Text]
167. Schatz IJ, Podolsky S, Frame B. Idiopathic orthostatic hypotension. Diagnosis and treatment. JAMA. 1963 Nov 9;186(6):537-40.[Abstract]
168. Levin JM, Ravenna P, Weiss M. Idiopathic orthostatic hypotension. Treatment with a commercially available counterpressure suit. Arch Intern Med. 1964 Jul;114(1):145-8.[Abstract]
169. Lewis HD Jr, Dunn M. Orthostatic hypotension syndrome. A case report. Am Heart J. 1967 Sep;74(3):396-401.[Abstract]
170. Sheps SG. Use of an elastic garment in the treatment of orthostatic hypotension. Cardiology. 1976;61 suppl 1:271-9.[Abstract]
171. Tanaka H, Yamaguchi H, Tamai H. Treatment of orthostatic intolerance with inflatable abdominal band. Lancet. 1997 Jan 18;349(9046):175.[Abstract]
172. Smit AA, Hardjowijono MA, Wieling W. Are portable folding chairs useful to combat orthostatic hypotension? Ann Neurol. 1997 Dec;42(6):975-8.[Abstract]
173. van Lieshout JJ, ten Harkel AD, Wieling W. Physical manoeuvres for combating orthostatic dizziness in autonomic failure. Lancet. 1992 Apr 11;339(8798):897-8.[Abstract]
174. Schatz IJ, Miller MJ, Frame B. Corticosteroids in the management of orthostatic hypotension. Cardiology. 1976;61 suppl 1:280-9.[Abstract]
175. van Lieshout JJ, ten Harkel AD, Wieling W. Fludrocortisone and sleeping in the head-up position limit the postural decrease in cardiac output in autonomic failure. Clin Auton Res. 2000 Feb;10(1):35-42.[Abstract]
176. Hickler RB, Thompson GR, Fox LM, et al. Successful treatment of orthostatic hypotension with 9-alpha-fluorohydrocortisone. N Engl J Med. 1959 Oct 15;261:788-91.[Abstract]
177. Bannister R, Ardill L, Fentem P. An assessment of various methods of treatment of idiopathic orthostatic hypotension. Q J Med. 1969 Oct;38(152):377-95.[Abstract]
178. Campbell IW, Ewing DJ, Clarke BF. Therapeutic experience with fludrocortisone in diabetic postural hypotension. Br Med J. 1976 Apr 10;1(6014):872-4.[Abstract][Full Text]
179. Chobanian AV, Volicer L, Tifft CP, et al. Mineralocorticoid-induced hypertension in patients with orthostatic hypotension. N Engl J Med. 1979 Jul 12;301(2):68-73.[Abstract]
180. Robertson D, Davis TL. Recent advances in the treatment of orthostatic hypotension. Neurology. 1995 Apr;45(4 Suppl 5):S26-32.[Abstract]
181. Zachariah PK, Bloedow DC, Moyer TP, et al. Pharmacodynamics of midodrine, an antihypotensive agent. Clin Pharmacol Ther. 1986 May;39(5):586-91.[Abstract]
182. McTavish D, Goa KL. Midodrine. A review of its pharmacological properties and therapeutic use in orthostatic hypotension and secondary hypotensive disorders. Drugs. 1989 Nov;38(5):757-77.[Abstract]
183. Low PA, Gilden JL, Freeman R, et al. Efficacy of midodrine vs placebo in neurogenic orthostatic hypotension. A randomized, double-blind multicenter study. Midodrine Study Group. JAMA. 1997 Apr 2;277(13):1046-51. [Erratum in: JAMA. 1997 Aug 6;278(5):388.][Abstract]
184. Kaufmann H, Brannan T, Krakoff L, et al. Treatment of orthostatic hypotension due to autonomic failure with a peripheral alpha-adrenergic agonist (midodrine). Neurology. 1988 Jun;38(6):951-6.[Abstract]
185. Wright RA, Kaufmann HC, Perera R, et al. A double-blind, dose-response study of midodrine in neurogenic orthostatic hypotension. Neurology. 1998 Jul;51(1):120-4.[Abstract]
186. Freeman R. Treatment of orthostatic hypotension. Semin Neurol. 2003 Dec;23(4):435-42.[Abstract]
187. Mathias CJ, Kimber JR. Treatment of postural hypotension. J Neurol Neurosurg Psychiatry. 1998 Sep;65(3):285-9.[Abstract]
188. European Medicines Agency. Pseudoephedrine-containing medicinal products - referral. Mar 2024 [internet publication].[Full Text]
189. Winkler AS, Landau S, Watkins P, et al. Observations on haematological and cardiovascular effects of erythropoietin treatment in multiple system atrophy with sympathetic failure. Clin Auton Res. 2002 Jun;12(3):203-6.[Abstract]
190. Hoeldtke RD, Streeten DH. Treatment of orthostatic hypotension with erythropoietin. N Engl J Med. 1993 Aug 26;329(9):611-5.[Abstract][Full Text]
191. Perera R, Isola L, Kaufmann H. Effect of recombinant erythropoietin on anemia and orthostatic hypotension in primary autonomic failure. Clin Auton Res. 1995 Sep;5(4):211-3.[Abstract]
192. Vinik AI. Diabetic neuropathy: pathogenesis and therapy. Am J Med. 1999 Aug 30;107(2B):17-26S.[Abstract]
193. Vinik AI. Diagnosis and management of diabetic neuropathy. Clin Geriatr Med. 1999 May;15(2):293-320.[Abstract]
194. Verne GN, Sninsky CA. Diabetes and the gastrointestinal tract. Gastroenterol Clin North Am. 1998 Dec;27(4):861-74, vi-vii.[Abstract]
195. Peeters T, Matthijs G, Depoortere I, et al. Erythromycin is a motilin receptor agonist. Am J Physiol. 1989 Sep;257(3 Pt 1):G470-4.[Abstract]
196. Richards RD, Davenport K, McCallum RW. The treatment of idiopathic and diabetic gastroparesis with acute intravenous and chronic oral erythromycin. Am J Gastroenterol. 1993 Feb;88(2):203-7.[Abstract]
197. DiBaise JK, Quigley EM. Efficacy of prolonged administration of intravenous erythromycin in an ambulatory setting as treatment of severe gastroparesis: one center's experience. J Clin Gastroenterol. 1999 Mar;28(2):131-4.[Abstract]
198. Sturm A, Holtmann G, Goebell H, et al. Prokinetics in patients with gastroparesis: a systematic analysis. Digestion. 1999 Sep-Oct;60(5):422-7.[Abstract]
199. European Medicines Agency. European Medicines Agency recommends changes to the use of metoclopramide. Jul 2013 [internet publication].[Full Text]
200. Horowitz M, Harding PE, Chatterton BE, et al. Acute and chronic effects of domperidone on gastric emptying in diabetic autonomic neuropathy. Dig Dis Sci. 1985 Jan;30(1):1-9.[Abstract]
201. Patterson D, Abell T, Rothstein R, et al. A double-blind multicenter comparison of domperidone and metoclopramide in the treatment of diabetic patients with symptoms of gastroparesis. Am J Gastroenterol. 1999 May;94(5):1230-4.[Abstract]
202. Ahmad N, Keith-Ferris J, Gooden E, et al. Making a case for domperidone in the treatment of gastrointestinal motility disorders. Curr Opin Pharmacol. 2006 Dec;6(6):571-6.[Abstract]
203. Lacy BE, Zayat EN, Crowell MD, et al. Botulinum toxin for the treatment of gastroparesis: a preliminary report. Am J Gastroenterol. 2002 Jun;97(6):1548-52.[Abstract]
204. Ezzeddine D, Jit R, Katz N, et al. Pyloric injection of botulinum toxin for treatment of diabetic gastroparesis. Gastrointest Endosc. 2002 Jun;55(7):920-3.[Abstract]
205. Lacy BE, Crowell MD, Schettler-Duncan A, et al. The treatment of diabetic gastroparesis with botulinum toxin injection of the pylorus. Diabetes Care. 2004 Oct;27(10):2341-7.[Abstract]
206. McCallum RW, Chen JD, Lin Z, et al. Gastric pacing improves emptying and symptoms in patients with gastroparesis. Gastroenterology. 1998 Mar;114(3):456-61.[Abstract]
207. National Health Service England. Clinical commissioning policy: gastroelectrical stimulation for gastroparesis. Jul 2016 [internet publication].[Full Text]
208. Green PA, Berge KG, Sprague RG. Control of diabetic diarrhea with antibiotic therapy. Diabetes. 1968 Jun;17(6):385-7.[Abstract][Full Text]
209. Tsai ST, Vinik AI, Brunner JF. Diabetic diarrhea and somatostatin. Ann Intern Med. 1986 Jun;104(6):894.[Abstract]
210. von der Ohe MR, Camilleri M, Thomforde GM, et al. Differential regional effects of octreotide on human gastrointestinal motor function. Gut. 1995 May;36(5):743-8.[Abstract][Full Text]
211. Phé V, Rouprêt M. Erectile dysfunction and diabetes: a review of the current evidence-based medicine and a synthesis of the main available therapies. Diabetes Metab. 2012 Feb;38(1):1-13.[Abstract]
212. Rendell MS, Rajfer J, Wicker PA, et al. Sildenafil for treatment of erectile dysfunction in men with diabetes: a randomized controlled trial. Sildenafil Diabetes Study Group. JAMA. 1999 Feb 3;281(5):421-6.[Abstract][Full Text]
213. Goldstein I, Kim E, Steers WD, et al. Efficacy and safety of tadalafil in men with erectile dysfunction with a high prevalence of comorbid conditions: results from MOMENTUS: multiple observations in men with erectile dysfunction in National Tadalafil Study in the US. J Sex Med. 2007 Jan;4(1):166-75.[Abstract]
214. Virag R, Frydman D, Legman M, et al. Intracavernous injection of papaverine as a diagnostic and therapeutic method in erectile failure. Angiology. 1984 Feb;35(2):79-87.[Abstract]
215. Spollett GR. Assessment and management of erectile dysfunction in men with diabetes. Diabetes Educ. 1999 Jan-Feb;25(1):65-73.[Abstract]
216. Cuzin B. Alprostadil cream in the treatment of erectile dysfunction: clinical evidence and experience. Ther Adv Urol. 2016 Aug;8(4):249-56.[Abstract][Full Text]
217. Saulie BA, Campbell RK. Treating erectile dysfunction in diabetes patients. Diabetes Educ. 1997 Jan-Feb;23(1):29-33, 35-6, 38.[Abstract]
218. Pfeifer MA, Schumer MP, Gelber DA. Aldose reductase inhibitors: the end of an era or the need for different trial designs? Diabetes. 1997 Sep;46 Suppl 2:S82-9.[Abstract]
219. Hotta N, Toyota T, Matsuoka K, et al; SNK-860 Diabetic Neuropathy Study Group. Clinical efficacy of fidarestat, a novel aldose reductase inhibitor, for diabetic peripheral neuropathy: a 52-week multicenter placebo-controlled double-blind parallel group study. Diabetes Care. 2001 Oct;24(10):1776-82.[Abstract]
220. Asano T, Saito Y, Kawakami M, et al; Fidarestat Clinical Pharmacology Study Group. Fidarestat (SNK-860), a potent aldose reductase inhibitor, normalizes the elevated sorbitol accumulation in erythrocytes of diabetic patients. J Diabetes Complications. 2002 Mar-Apr;16(2):133-8.[Abstract]
221. Bril V, Buchanan RA. Long-term effects of ranirestat (AS-3201) on peripheral nerve function in patients with diabetic sensorimotor polyneuropathy. Diabetes Care. 2006 Jan;29(1):68-72.[Abstract][Full Text]
222. Bril V, Hirose T, Tomioka S, et al. Ranirestat Study Group. Ranirestat for the management of diabetic sensorimotor polyneuropathy. Diabetes Care. 2009 Jul;32(7):1256-60.[Abstract][Full Text]
223. Hotta N, Kawamori R, Atsumi Y, et al. ADCT Study Group. Stratified analyses for selecting appropriate target patients with diabetic peripheral neuropathy for long-term treatment with an aldose reductase inhibitor, epalrestat. Diabet Med. 2008 Jul;25(7):818-25.[Abstract][Full Text]
224. Chalk C, Benstead TJ, Moore F. Aldose reductase inhibitors for the treatment of diabetic polyneuropathy. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD004572.[Abstract][Full Text]
225. Stavniichuk R, Drel VR, Shevalye H, et al. Baicalein alleviates diabetic peripheral neuropathy through inhibition of oxidative-nitrosative stress and p38 MAPK activation. Exp Neurol. 2011 Jul;230(1):106-13.[Abstract]
226. Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a 7-month multicenter randomized controlled trial (ALADIN III Study). ALADIN III Study Group. Alpha-Lipoic Acid in Diabetic Neuropathy. Diabetes Care. 1999 Aug;22(8):1296-301.[Abstract]
227. Ziegler D, Reljanovic M, Mehnert H, et al. Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials. Exp Clin Endocrinol Diabetes. 1999;107(7):421-30.[Abstract]
228. Ametov AS, Barinov A, Dyck PJ, et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial. Diabetes Care. 2003 Mar;26(3):770-6.[Abstract][Full Text]
229. Ziegler D, Low PA, Litchy WJ, et al. Efficacy and safety of antioxidant treatment with alpha-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial. Diabetes Care. 2011 Sep;34(9):2054-60.[Abstract]
230. Mijnhout GS, Kollen BJ, Alkhalaf A, et al. Alpha lipoic acid for symptomatic peripheral neuropathy in patients with diabetes: a meta-analysis of randomized controlled trials. Int J Endocrinol. 2012;2012:456279.[Abstract][Full Text]
231. Apfel SC, Kessler JA, Adornato BT, et al. Recombinant human nerve growth factor in the treatment of diabetic polyneuropathy. NGF Study Group. Neurology. 1998 Sep;51(3):695-702.[Abstract]
232. Apfel SC. Nerve growth factor for the treatment of diabetic neuropathy: what went wrong, what went right, and what does the future hold? Int Rev Neurobiol. 2002;50:393-413.[Abstract]
233. Quatraro A, Roca P, Donzella C, et al. Acetyl-L-carnitine for symptomatic diabetic neuropathy. Diabetologia. 1995 Jan;38(1):123.[Abstract]
234. Onofrj M, Fulgente T, Melchionda D, et al. L-acetylcarnitine as a new therapeutic approach for peripheral neuropathies with pain. Int J Clin Pharmacol Res. 1995;15(1):9-15.[Abstract]
235. Scarpini E, Sacilotto G, Baron P, et al. Effect of acetyl-L-carnitine in the treatment of painful peripheral neuropathies in HIV+ patients. J Peripher Nerv Syst. 1997;2(3):250-2.[Abstract]
236. Evans JD, Jacobs TF, Evans EW. Role of acetyl-L-carnitine in the treatment of diabetic peripheral neuropathy. Ann Pharmacother. 2008 Nov;42(11):1686-91.[Abstract]
237. Sima AA, Calvani M, Mehra M, et al. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials. Diabetes Care. 2005 Jan;28(1):89-94.[Abstract][Full Text]
238. Drel VR, Pacher P, Stavniichuk R, et al. Poly(ADP-ribose)polymerase inhibition counteracts renal hypertrophy and multiple manifestations of peripheral neuropathy in diabetic Akita mice. Int J Mol Med. 2011 Oct;28(4):629-35.[Abstract][Full Text]
239. Sima AA, Kamiya H. Is C-peptide replacement the missing link for successful treatment of neurological complications in type 1 diabetes? Curr Drug Targets. 2008 Jan;9(1):37-46.[Abstract]
240. Ekberg K, Brismar T, Johansson BL, et al. C-peptide replacement therapy and sensory nerve function in type 1 diabetic neuropathy. Diabetes Care. 2007 Jan;30(1):71-6.[Abstract][Full Text]
241. Ekberg K, Brismar T, Johansson BL, et al. Amelioration of sensory nerve dysfunction by C-peptide in patients with type 1 diabetes. Diabetes. 2003 Feb;52(2):536-41.[Abstract][Full Text]
242. ClinicalTrials.gov. Safety and efficacy of CBX129801 in patients with type 1 diabetes. NCT01681290. Jan 2015 [internet publication].[Full Text]
243. Fonseca VA, Lavery LA, Thethi TK, et al. Metanx in type 2 diabetes with peripheral neuropathy: a randomized trial. Am J Med. 2013 Feb;126(2):141-9.[Abstract][Full Text]
244. Rowbotham MC, Arslanian A, Nothaft W, et al. Efficacy and safety of the alpha(4)beta(2) neuronal nicotinic receptor agonist ABT-894 in patients with diabetic peripheral neuropathic pain. Pain. 2012 Apr;153(4):862-8.[Abstract]
245. Tack J, Depoortere I, Bisschops R, et al. Influence of ghrelin on gastric emptying and meal-related symptoms in idiopathic gastroparesis. Aliment Pharmacol Ther. 2005 Nov 1;22(9):847-53.[Abstract]
246. Ejskjaer N, Wo JM, Esfandyari T, et al. A phase 2a, randomized, double-blind 28-day study of TZP-102, a ghrelin receptor agonist for diabetic gastroparesis. Neurogastroenterol Motil. 2013 Feb;25(2):e140-50.[Abstract]
247. McCallum RW, Lembo A, Esfandyari T, et al; TZP-102 Phase 2b Study Group. Phase 2b, randomized, double-blind 12-week studies of TZP-102, a ghrelin receptor agonist for diabetic gastroparesis. Neurogastroenterol Motil. 2013 Nov;25(11):e705-17.[Abstract]
248. Krendel DA, Costigan DA, Hopkins LC. Successful treatment of neuropathies in patients with diabetes mellitus. Arch Neurol. 1995 Nov;52(11):1053-61.[Abstract]
249. Krendel DA, Zacharias A, Younger DS. Autoimmune diabetic neuropathy. Neurol Clin. 1997 Nov;15(4):959-71.[Abstract]
250. Pascoe MK, Low PA, Windebank AJ, et al. Subacute diabetic proximal neuropathy. Mayo Clin Proc. 1997 Dec;72(12):1123-32.[Abstract]
251. Jaradeh SS, Prieto TE, Lobeck LJ. Progressive polyradiculoneuropathy in diabetes: correlation of variables and clinical outcome after immunotherapy. J Neurol Neurosurg Psychiatry. 1999 Nov;67(5):607-12.[Abstract][Full Text]
252. Ites KI, Anderson EJ, Cahill ML, et al. Balance interventions for diabetic peripheral neuropathy: a systematic review. J Geriatr Phys Ther. 2011 Jul-Sep;34(3):109-16.[Abstract]
253. Baba M, Matsui N, Kuroha M, et al. Mirogabalin for the treatment of diabetic peripheral neuropathic pain: a randomized, double-blind, placebo-controlled phase III study in Asian patients. J Diabetes Investig. 2019 Sep;10(5):1299-306.[Abstract][Full Text]
254. Taheri A, Farbood A, Heshmat R, et al. The effect of transdermal nitroglycerin on pain control in diabetic patients with peripheral neuropathy. J Diabetes Metab Disord. 2015 Dec 1;14:86.[Abstract][Full Text]
255. Rayman G, Baker NR, Krishnan ST. Glyceryl trinitrate patches as an alternative to isosorbide dinitrate spray in the treatment of chronic painful diabetic neuropathy. Diabetes Care. 2003 Sep;26(9):2697-8.[Abstract][Full Text]
256. Blonde L, Umpierrez GE, Reddy SS, et al. American Association of Clinical Endocrinology clinical practice guideline: developing a diabetes mellitus comprehensive care plan-2022 update. Endocr Pract. 2022 Oct;28(10):923-1049.[Abstract][Full Text]
257. Diabetes UK. Diabetes and emotional health - a practical guide for healthcare professionals supporting adults with type 1 and type 2 diabetes. 2019 [internet publication].[Full Text]
258. Frykberg RG, Zgonis T, Armstrong DG, et al; American College of Foot and Ankle Surgeons. Diabetic foot disorders. A clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006 Sep-Oct;45(5 Suppl):S1-66.[Abstract][Full Text]
259. Calles-Escandón J, Lovato LC, Simons-Morton DG, et al. Effect of intensive compared with standard glycemia treatment strategies on mortality by baseline subgroup characteristics: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Care. 2010 Apr;33(4):721-7.[Abstract][Full Text]
260. Arad Y, Fonseca V, Peters A, et al. Beyond the monofilament for the insensate diabetic foot: a systematic review of randomized trials to prevent the occurrence of plantar foot ulcers in patients with diabetes. Diabetes Care. 2011 Apr;34(4):1041-6.[Abstract][Full Text]
Key Articles
Referenced Articles
Sign in to access our clinical decision support tools