Diabetic Neuropathic Pain: An Update and Novel Pharmacological Strategies for Relief of Pain

Abstract

Diabetic neuropathy is one of the most painful complications of diabetes mellitus, involving progressive neuronal damage and dysfunction and up to 30% of patients with diabetes mellitus developed diabetic neuropathy. Pain caused by diabetic neuropathy is debilitating and often is refractory to classical analgesic, including morphine. The mechanisms underlying cause of diabetic neuropathic pain are complex and both peripheral and central components of the sensory systems are reported to be involved in progression and maintenance of neuropathy. This study summarises data on pathogenesis and on existing and new analgesics such as NSAIDS, opioids, anti-epileptic, membrane stabilising and anti-depressant drugs, that are the mainstay of treatment for alleviating diabetic neuropathic pain. In addition, novel pharmacological approaches and strategies for analgesics such as use of drug combination and their implications will be discussed.