Perspectives in Diabetic Neuropathy: Update on Diagnostic Criteria and Treatment Options

Diabetic sensorimotor polyneuropathy (DSPN) is a common complication in patients with diabetes, >10 % of whom suffer from severe neuropathic pain. DSPN diagnosis remains challenging despite the breath of diagnostic tools; this is partly due to varying proficiency amongst examiners, but also variations in diagnostic criteria employed. Treatment options include pathogenesis-oriented and symptomatic approaches. Symptomatic pharmacotherapy in painful DSPN aims to ease neuropathic pain using analgesics such as the tricyclic antidepressants serotonin-noradrenaline reuptake inhibitors and alpha(2)delta ligands, but evidence points to pathogenesis-oriented treatments using alpha lipoic acid or benfotiamine. Combination therapy has also emerged as an important approach in DSPN treatment. In this review, we aim to update the current diagnostic and therapeutic options for DSPN.