Abstract | BACKGROUND: AIM: This document summarizes consensus recommendations regarding appropriate treatment for refractory peripheral diabetic neuropathy (PDN), based on outcomes from an expert panel convened on December 10, 2022, as part of the Worldwide Initiative for Diabetes Education Virtual Global Summit, "Advances in the Management of Painful Diabetic Neuropathy." PARTICIPANTS: Nine attendees, eminent physicians and academics, comprising six diabetes specialists, two pain specialists, and one health services expert. EVIDENCE: For individuals with refractory PDN, opioids are a high-risk option that do not provide a long-term solution and should not be used. For appropriately selected individuals, SCS is an effective, safe, and durable treatment option. In particular, high-frequency (HF) SCS (10 kHz) shows strong efficacy and improves quality of life. To ensure treatment success, strict screening criteria should be used to prioritize candidates for SCS. CONSENSUS PROCESS: Each participant voiced their opinion after reviewing available data, and a verbal consensus was reached during the meeting. CONCLUSION: Globally, the use of opioids should rarely be recommended for refractory, severe PDN. Based on increasing clinical evidence, SCS, especially HF-SCS, should be considered as a treatment for PDN that is not responsive to first- or second-line monotherapy/dual therapy.
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Authors | A J M Boulton, T S Jensen, T Luecke, E A Petersen, R Pop-Busui, R S Taylor, S Tesfaye, L Vileikyte, D Ziegler |
Journal | Diabetes research and clinical practice
(Diabetes Res Clin Pract)
Vol. 206 Suppl 1
Pg. 110763
(Dec 2023)
ISSN: 1872-8227 [Electronic] Ireland |
PMID | 38245326
(Publication Type: Journal Article)
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Copyright | Copyright © 2023. Published by Elsevier B.V. |
Topics |
- Humans
- Diabetic Neuropathies
(diagnosis)
- Spinal Cord Stimulation
- Quality of Life
- Treatment Outcome
- Neuralgia
(etiology, therapy)
- Diabetes Mellitus
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