Recommendations: Neuropathy Screening, Treatment (2)
Recommendations for the screening and treatment of neuropathy in patients with diabetes1 are summarized in two slides Slide 2 of 2 Screening for signs and symptoms of cardiovascular autonomic neuropathy should be instituted at diagnosis of type 2 diabetes and 5 years after the diagnosis of type 1 diabetes; special testing is rarely needed and may not affect management or outcomes (E) Medications for the relief of specific symptoms related to DPN and autonomic neuropathy are recommended, as they improve the quality of life of the patient (E) Specific treatment for the underlying nerve damage is not currently available, other than improved glycemic control, which may modestly slow progression2 but not reverse neuronal loss; effective symptomatic treatments are available for some manifestations of DPN3 and autonomic neuropathy104Reference American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S37-S38. Ismail-Beigi F, Craven T, Banerji MA, et al for the 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;376:419-430. Bril V, England J, Franklin GM, et al for the American Academy of Neurology; American Association of Neuromuscular and Electrodiagnostic Medicine; American Academy of Physical Medicine and Rehabilitation. Evidence-based guideline: treatment of painful diabetic neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2011;76:1758–1765.