Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 31 (4), 253-260

Therapeutic Alternatives in Painful Diabetic Neuropathy: A Meta-Analysis of Randomized Controlled Trials

Affiliations
Review

Therapeutic Alternatives in Painful Diabetic Neuropathy: A Meta-Analysis of Randomized Controlled Trials

Samuel Vilar et al. Korean J Pain.

Abstract

Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology.

Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity.

Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05].

Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

Keywords: Chronic pain; Diabetes complications; Diabetic neuropathies; Pain; Pain management; Pain unit.

Figures

Fig. 1
Fig. 1. Flow diagram of the included studies.
Fig. 2
Fig. 2. Risk of bias summary.
Fig. 3
Fig. 3. Risk of bias graph.
Fig. 4
Fig. 4. Forest plot of meta-analytic results.

Similar articles

See all similar articles

Cited by 1 PubMed Central articles

References

    1. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40–50. - PubMed
    1. Asociación Española de Enfermería Vascular y Heridas (AEEVH) Guía de práctica clínica: consenso sobre úlceras vasculares y pie diabético. Segunda edición. Seville: Asociación Española de Enfermería Vascular y Heridas; 2014. pp. 1–90.
    1. Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28:956–962. - PubMed
    1. Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17:1113–1123. e67–e88. - PubMed
    1. Stein C, Eibel B, Sbruzzi G, Lago PD, Plentz RD. Electrical stimulation and electromagnetic field use in patients with diabetic neuropathy: systematic review and meta-analysis. Braz J Phys Ther. 2013;17:93–104. - PubMed

LinkOut - more resources

Feedback