摘要
The diabetic neuropathies are a heterogeneous group of disorders with diverse clinical manifestations. The early recognition and appropriate management of neuropathy in the patient with diabetes is required. The most important treatment of diabetic neuropathy is optimal glucose control. Foot care is crucial to prevent ulceration, infection, and amputation. For patients with painful diabetic neuropathy, we suggest initial therapy using either amitriptyline or venlafaxine, duloxetine or pregabalin. If patients fail with single drug therapy, it is recommended that the composite treatment using two different classes of drugs. Alternative replacement therapy, including capsaicin cream, lidocaine patch, a-lipoic acid or transcutaneous electrical nerve stimulation. A new section was added in this standard medical care to describe the mixed evidence on the use of hyperbaric oxygen therapy in people with diabetic foot ulcers. Gabapentin was added to the list of agents to be considered for the treatment of neuropathic pain in people with diabetes based on data on efficacy and the potential for cost savings. The gastroparesis section includes a discussion of a few additional treatment modalities. The recommendation for patients with diabetes to have their feet inspected at every visit was modified to only include those at high risk for ulceration. Annual examinations remain recommended for everyone. (J Intern Med Taiwan 2019; 30: 368-379).
原文 | English |
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頁(從 - 到) | 368-379 |
頁數 | 12 |
期刊 | Journal of Internal Medicine of Taiwan |
卷 | 30 |
發行號 | 6 |
DOIs | |
出版狀態 | Published - 2019 12月 |
All Science Journal Classification (ASJC) codes
- 內科學