Pathophysiology and treatment of painful diabetic neuropathy of the lower extremity

R P Wunderlich, E J Peters, J Bosma, D G Armstrong

Research output: Contribution to journalReview articleAcademicpeer-review

13 Citations (Scopus)


BACKGROUND: Symptomatic peripheral neuropathy is the most common complication of diabetes mellitus, affecting up to 62% of Americans with diabetes.

METHODS: We reviewed the literature using the National Library of Medicine's MEDLINE search service. In total, we reviewed 54 articles.

RESULTS: Hyperglycemia leads to increased activity in the polyol pathway in nerve cells; this ultimately results in abnormal nerve function. Numerous pharmacologic agents have been used to treat symptomatic peripheral neuropathy, but all of these drugs can be associated with adverse side effects. Recent work has indicated that subsensory electrical stimulation may be preferred to pharmacotherapy, since it is equally effective and has a more favorable safety profile.

CONCLUSION: Although the pathophysiology of diabetic neuropathy is well understood, treatment of the symptoms associated with this condition can be challenging. Additional research is needed to reveal a safe and effective treatment for this debilitating sequela of diabetes mellitus.

Original languageEnglish
Pages (from-to)894-8
Number of pages5
JournalSAMJ. South African medical Journal
Issue number10
Publication statusPublished - Oct 1998


  • Diabetic Neuropathies/physiopathology
  • Humans
  • Pain Management
  • Pain/physiopathology
  • Transcutaneous Electric Nerve Stimulation

Cite this