Index A Alpha-lipoic acid (ALA) , 91, 123 Acceptance and commitment therapy Alternative treatments (ACT) , 75, 76, 78 CAM, western society , 84 Acetyl L -carnitine (ALC) , 91, 129 mind-body therapies , 89–91 ACT. See Acceptance and commitment nutraceuticals therapy (ACT) ALA , 91 Acupuncture ALC , 91 alternative medicine techniques , 85 benfotiamine , 91 chemotherapy-induced peripheral fatty acids , 92 neuropathy , 89 vitamin B12 de fi ciency , 92 Chinese medicine , 84 zinc , 92 description , 66 osteopathic medicine , 83 DPN patients , 187–188 stimulation-based therapies moxibustion , 86 ( see Acupuncture) multicenter randomized controlled traditional medicine , 83 trial , 88–89 American Diabetes Association (ADA) , needles , 86 194–195 opioid receptors and endorphins , 85 Amyotrophy serotonin receptors , 85 asymmetrical proximal leg side effects , 88 weakness , 162 TCM , 86, 88 DPN , 162 timeline , 86, 87 ESR , 162 Acute painful neuropathy MRI, CT/ultrasound , 162 poor glycaemic control , 157 pain , 162 rapid glycaemic control (insulin neuritis) , type 1 and type 2 diabetic patients , 162 157–158 Anticonvulsants, DPN transient neuropathic syndromes , 157 adverse event related withdrawal , Advanced practice registered nurses 178–179 (APRNs) , 142 effects, quality of life and physical ALA. See Alpha-lipoic acid (ALA) functioning , 178 ALC. See Acetyl L -carnitine (ALC) ef fi cacy, individual , 178 Aldose reductase inhibitors (ARI) , 128 epilepsy , 177 Allodynia , 17–19 impacts , 179 Alpha-2-delta ligand agonist antiepileptic inhibition , 177 drugs , 52–53 literature review , 177 E. Lawson and M. “Misha” Backonja (eds.), Painful Diabetic Polyneuropathy: 197 A Comprehensive Guide for Clinicians, DOI 10.1007/978-1-4614-6299-6, © Springer Science+Business Media New York 2013 198 Index Antidepressants, DPN RCT , 74 adverse event related withdrawal , 176 Community depression , 174 activity , 142 ef fi cacy , 176 health care , 149, 150 impacts , 177 housing , 142 individual ef fi cacy , 175, 176 older adults , 144 SNRIs , 175 retirement , 143 TCAs , 175–176 Complementary and alternative medicine typical and atypical groups , 175 (CAM) Antiepileptic drugs , 53 mindful and meditative therapies , 89 APRNs. See Advanced practice registered organization , 84 nurses (APRNs) osteopathic manipulative treatment , 83 ARI. See Aldose reductase inhibitors (ARI) western society , 84 Asymmetrical neuropathies Cornal confocal microscopy (CCM) , 31 cranial mononeuropathy , 163 Cranial neuropathies , 163 diabetes , 162 pressure palsies ( see Pressure palsies) proximal motor/amyotrophy , 162 D truncal radiculopathy , 163 Descending inhibition , 21 Diabetes mellitus description , 13 B insulin treatment , 39 Balneotherapy , 65 metabolic disorders , 155 Benfotiamine , 91 Diabetic neuropathy (DN) ALC , 91 asymmetrical ( see Asymmetrical C neuropathies) Calcium channel modulators , 124–125 benfotiamine , 91 CAM. See Complementary and alternative CAM , 84 medicine (CAM) chronic pain , 90 Cannabinoids , 182–183 clinical presentations , 130 Capsaicin , 54, 66, 126, 183 duloxetine , 131 Capsaicin dermal patch fatty acids , 92 complications , 100 insensitivity and weakness , 155 FDA , 98 long-term complications , 155 PGIC , 99 management, patients , 131, 132 procedure , 99 mononeuropathy , 28 TRPV-1 , 98, 99 neurodegeneration , 14 Carbamazepine , 31 neuropathic pain , 49–50 Carpal tunnel syndrome , 163 painful and painless , 14 CBT. See Cognitive behavioral therapy (CBT) painful symptoms , 155 CCM. See Cornal confocal microscopy (CCM) pharmacological treatments CDC. See Centers for disease control and ( see Pharmacological treatments) prevention (CDC) physical and mental QOL , 121 Centers for disease control and prevention polyneuropathy , 28 (CDC) , 194 side effects , 131, 133 Central nervous system (CNS) symmetrical ( see Symmetrical painful neuropathy , 21 neuropathies) zinc , 92 symptoms , 122 Central sensitization , 52 trial design , 131 Chronic hyperglycemia , 39, 40 vitamin B12 de fi ciency , 92 Cognitive behavioral therapy (CBT) zinc , 92 ACT , 75 Diabetic painful neuropathy (DPN). neuropathic pain , 74 See Painful diabetic neuropathy psychological treatment methods , 73 (PDN) Index 199 Diabetic peripheral neuropathy (DPN) DN. See Diabetic neuropathy (DN) acute hyperglycemia/insulin therapy , 38 DPN. See Diabetic peripheral neuropathy chronic , 160 (DPN) diagnosis , 157–158 Drugs, DPN direct medical costs , 108–111 anticonvulsants ( see Anticonvulsants, drug therapy , 157 DPN) epidemiology , 108, 158–159 antidepressants ( see Antidepressants, foot ulcer , 157 DPN) health status and functioning , 111–114 cannabinoids , 182–183 hyperglycemia , 107 ion channel blockers , 181–182 implications, clinicians , 115–116 NMDA antagonists , 182 interventional therapies , 95, 102 opioids , 180 Melzack–Wall gate theory , 96, 97 topical analgesics ( see Topical analgesics, modalities , 157 DPN) MRI , 156–157 tramadol , 181 nerve fi bers , 37 nociceptive neurons , 99 nursing and home care ( see Nursing and E home care, PDPN) Electromagnetic therapy, DPN , 187 pain and metabolic control , 40 Electrotherapy, DPN pain assessment , 161–162 magnetic , 187 pathogenesis , 38 natural electricity , 185 pDPN , 115 pain management , 186 peripheral neutropathy and metabolic TENS , 186 control , 38–40 Epidemiology, PDN preventive and therapeutic strategies , de fi nition , 3–4 42–45 glycemic control , 8 Romberg’s sign , 157 health care burden , 5–6 screening , 41–42 length-dependent polyneuropathy , 4 sleep deprivation , 157 long-term longitudinal data , 7 small fi bers , 37 microvascular complications , 5 symmetrical and asymmetrical National Diabetes Fact Sheet , 2011, 7 neuropathies , 37, 38 nonmonetary burdens , 6–7 symptoms , 156 non-neuropathy pain , 4 unpleasant sensory symptoms , 157 pain and diabetic neuropathy , 4 work productivity , 114–115 Erythrocyte sedimentation rate (ESR) , 162 Diagnosis, PDN ESR. See Erythrocyte sedimentation rate carbamazepine , 31 (ESR) clinical presentation Exercise therapy , 64 “dying-back” , 27–28 “glove-and-stocking” , 28 non-neuropathic pain disorders , 29 F NPQ , 29 Fatty acids , 92 physical examination , 28 Food and Drug Administration (FDA) , 98, 100 screening tools , 28–29 Frequency-modulated electromagnetic neural symptoms , 28 stimulation (FREMS) , 187 types, neuropathy , 27, 28 con fi rmatory tests , 29–31 neuropathies , 32 G objective tests , 30, 33 GABA. See Gamma-aminobutyric acid Direct costs , 111 (GABA) Disease-modifying therapies Gabapentin , 52, 53, 56 ALA , 123 Gamma-aminobutyric acid (GABA) , 96 glycemic control , 122 Gamma-linolenic acid (GLA) , 92 200 Index Gene therapy , 129 L GLA. See Gamma-linolenic acid (GLA) Laser Doppler imager (LDI) fl are , 30–31 Glyceryl trinitrate (GTN) spray, DPN , 183 Laser therapy , 65 Graded exposure, PDN , 76 Lidocaine , 53–54, 126 H M HADS. See Hospital anxiety and depression Magnetic fi eld therapy , 64–65 scale (HADS) MBSR. See Mindfulness based stress Health status , 111–114 reduction (MBSR) HFEN. See High-frequency external muscle Medical training therapy , 64 stimulation (HFEN) Melzack–Wall gate theory , 96, 97 High-frequency external muscle stimulation Metabolic control (HFEN) , 187 microvascular complications , 41 Hospital anxiety and depression scale pain , 40 (HADS) , 162 and peripheral neutropathy ( see Peripheral Hyperalgesia neutropathy) ameliorate behavioral , 20 Mind-body therapies diabetic rats/mice , 18 ACT , 91 endogenous insulin/receiving insulin CAM treatments , 89 supplementation , 17 MBSR , 91 thermal hypoalgesia , 17 meditation, relaxation and yoga , 89, 90 TRPV4 receptor , 18 pain diagnoses , 91 Hyperglycemia , 107 PMR and autogenic training , 91 Hypnosis , 77 Mindfulness-based methods , 77–78 Mindfulness based stress reduction (MBSR) , 146 I Monoamine oxidase inhibitors (MAOIs) , 175 IENFD. See Intra-epidermal nerve fi ber density (IENFD) Indirect costs , 114, 115 N Insulin therapy , 14, 45 National Institute of Diabetes and Digestive Interventional therapies and Kidney Diseases (NIDDK) , 193 dorsal column SCS ( see Spinal cord National Institutes of Health (NIH) , 193–194 stimulation (SCS)) NCS. See Nerve conduction studies (NCS) DPN , 95 NDS. See Neurological disability score (NDS) high concentration capsaicin dermal Nerve conduction studies (NCS) , 29, 30 patch , 98–100 Neurodegeneration , 18 IT therapy , 100–102 Neurodegenerative disorders , 129 Intra-epidermal nerve fi ber density (IENFD) , Neurological disability score (NDS) , 14 30, 31 Neuropathic pain , 3–4, 49–50 Intrathecal (IT) therapy Neuropathic Pain Questionnaire (NPQ) , 29 infectious pathogen , 102 Neuropathic Pain Symptom Inventory (NPSI) , morphine , 100 29, 33 procedure description , 101–102 Neuropathic ulcers , 63 pump placement , 102 Neuropathic vs. non-neuropathic pain , 72–73 SAE , 101 NIDDK. See National Institute of Diabetes ziconotide , 100, 101 and Digestive and Kidney Diseases Ion channel blockers , 181–182 (NIDDK) Isosorbide dinitrate spray , 183 NIDDM. See Non-insulin-dependent diabetes IT therapy. See Intrathecal (IT) therapy mellitus (NIDDM) Index 201 NIH. See National Institutes of Health (NIH) pain management , 149 N -Methyl- D -Aspartate (NMDA) receptor PDPN risk , 142, 143 antagonists , 128–129, 182 polypharmacy , 144, 145 Nociceptor activation , 18 Opioid agonists , 55 Nociceptor activity , 19 Opioids, DPN Non-insulin-dependent diabetes mellitus acute and cancer pain management , 180 (NIDDM) , 167 tramadol, noradrenalin and serotonin Non-pharmacological management, PDN reuptake inhibitor