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Neuroscience. 2018 Sep 1;387:28-37. doi: 10.1016/j.neuroscience.2017.09.023. Epub 2017 Sep 20.

The Quest for more Research on Painful Diabetic Neuropathy.

Author information

1
University Hospital Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany; German Center for Diabetes Research (DZD), Germany; Joint Heidelberg-IDC Translational Diabetes Program, Helmholtz-Zentrum, München, Germany. Electronic address: peter.nawroth@med.uni-heidelberg.de.
2
University Hospital Heidelberg, Department of Neuroradiology, Heidelberg, Germany.
3
University Hospital Würzburg, Department of Neuroradiology, Würzburg, Germany.
4
Neuro Centrum Odenwald, Darmstadt, Germany.
5
Department of Anesthesiology and Intensive Care Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
6
Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
7
University of Heidelberg, Institute of Pharmacology, Heidelberg, Germany.
8
University Hospital Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany.
9
University Hospital Heidelberg, Department of Internal Medicine 1 and Clinical Chemistry, Heidelberg, Germany; German Center for Diabetes Research (DZD), Germany.

Abstract

A 62-year-old diabetologist diagnosed himself to have diabetes type-2, with an HbA1c of 9.5. Five months after lifestyle intervention and a multi-drug approach, HbA1c was 6.3, systolic blood pressure was below 135mmHg and BMI reduced to 27. But he suffered from severe painful diabetic neuropathy. Therefore he decided to visit his friend, a famous neuroscientist at an even more famous university. He asked him several plain questions: 1. What is the natural course of painful diabetic neuropathy? 2. Why do I have, despite almost normalizing HbA1c, more problems than before? 3. Are you sure my problems are due to diabetes or should we do a nerve biopsy? 4. Are there imaging techniques helpful for the diagnosis of this diabetic complication, starting in the distal nerve endings of the foot and slowly moving ahead? 5. Can you suggest any drug, specific and effective, for relieving painful diabetic neuropathy? This review will use the experts' answers to the questions of the diabetologist, not only to give a summary of the current knowledge, but even more to highlight areas of research needed for improving the fate of patients with painful diabetic neuropathy. Based on the unknowns, which exceed the knowns in diabetic neuropathy, a quest for more public support of research is made.

KEYWORDS:

painful diabetic neuropathy; patho-mechanisms of diabetic neuropathy

[Indexed for MEDLINE]

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