Diabetic Neuropathy Guidelines

University of Maryland Physician Takes Lead Role in New Recommendations

Newswise — Honolulu, HI – April 11, 2011. Many people with diabetes have nerve damage that causes pain, such as burning and tingling in their hands and feet, known as neuropathy. This is a chronic condition that can severely affect a person’s quality of life. Now a leading panel of neurologists, including a University of Maryland physician, has issued new recommendations to help doctors offer the most up-to-date treatments for people with diabetic neuropathy. The guideline is published in the April 11, 2011, online issue of Neurology®, the medical journal of American Academy of Neurology (AAN), and will be presented the same day at the American Academy of Neurology’s Annual Meeting in Honolulu.

“Diabetic nerve pain is treatable, and we now have clear guidelines for this disabling condition. Many patients with diabetic neuropathy are receiving inadequate treatment or no treatment at all. This is a significant problem as the number of people with diabetes increases across the United States,” says guideline author James Russell, M.D., professor of neurology, anatomy and neurobiology at the University of Maryland School of Medicine.

“Diabetic neuropathy is a painful and life-altering condition, so we need to find ways to help people who are suffering with it. These new recommendations provide physicians and patients the latest information, based on sound clinical research, so they can make the best decisions about their care,” adds Dr. Russell who is director of the Maryland Peripheral Neuropathy Center at the University of Maryland Medical Center. Dr. Russell is also associate chief of neurology at the Baltimore VA Medical Center. The neurology panel did an extensive review of the best scientific studies to create the guideline and specific drug recommendations. The guideline shows strong evidence that the seizure drug pregabalin is effective in treating diabetic nerve pain and can improve quality of life. However, pregabalin may not be appropriate for all patients.

The guideline also found that several other treatments are probably effective, including the seizure drugs gabapentin and valproate, antidepressants such as venlafaxine, duloxetine and amitriptyline, and painkillers such as opioids and capsaicin. The researchers also concluded that transcutaneous electric nerve stimulation (TENS), a portable electric device used to stimulate nerves, may be effective in treating diabetic nerve pain.

“Diabetes is one of the top health concerns facing the United States in the coming years. The University of Maryland School of Medicine has several research initiatives underway in an effort to understand and tackle this disease from many angles. Dr. Russell’s participation in these important diabetic neuropathy guidelines is another example of our commitment to do all we can to help patients with diabetes,” says E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and dean, University of Maryland School of Medicine.

According to the American Diabetes Association, nearly 26 million Americans are living with diabetes, including 7 million who do not know they have the disease. People with diabetes have high blood-sugar levels caused by problems with the body’s ability to produce and/or use insulin. Over time, excessive blood glucose levels can damage nerves, leading to diabetic neuropathy. Along with causing pain, numbness and tingling in the hands and feet, diabetic neuropathy can cause problems with vision and digestion, and it can affect the heart and blood vessels. More than half of all people with diabetes will develop some form of nervous system damage.

To create the diabetic neuropathy guidelines, the American Academy of Neurology team worked in collaboration with the American Association of Neuromuscular and Electrodiagnostic Medicine and the American Academy of Physical Medicine and Rehabilitation.