According to multicentric studies, duration and poor compensation of diabetes are the principal risk factors associated with the development of chronic diabetic complications, so the basis for the management is to maintain adequate metabolic compensation. Intensified insulin regimen is the most effective in the treatment of patients with type 1 diabetes. In patients with type 2 diabetes, administration of selected peroral antidiabetics or insulin therapy is considered. Physical activity, lifestyle and dietary management also contribute to euglycemia. Currently used management of DN includes supportive (alpha-lipoic acid, vitamins, antioxidants) and symptomatic treatment (painkillers, beta blockers, magnetotherapy). Other therapeutic possibilities are experimental so far. These drugs interfere with the pathophysiological processes and few of them have been shown to be beneficial in clinical studies (inhibitors of aldose reductase, selective inhibitor of protein kinase C beta, C peptide substitution), however, the effect of other medicines seems to be controversial (vascular endothelial growth factor, erythropoietin). This chapter brings comprehensive review about current possibilities and future perspectives in the management of diabetic neuropathy.
Total Pages: 227-296 (70)
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