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KEY POINTS

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  • Diabetic peripheral neuropathy is the most common type of peripheral neuropathy.

  • Control of the underlying condition (ie, diabetes) can help slow the progression of peripheral neuropathy.

  • MTM providers should educate patients regarding the importance of proper foot care.

  • Multiple medications can be used throughout the course of therapy for peripheral neuropathy.

  • MTM providers should work with the patient and prescribers to ensure that medications for peripheral neuropathy are properly titrated to symptom relief.

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INTRODUCTION

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The International Association for the Study of Pain (IASP) defines neuropathic pain as that "initiated or caused by a primary lesion or dysfunction in the nervous system."1 Peripheral neuropathy specifically describes damage to the peripheral nervous system. The nerve damage can cause changes in pain perception, enhanced sensory transmission, nerve structure reorganization, and loss of pain inhibition.2

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Causes of Peripheral Neuropathy

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Several different disease states and conditions have been known to cause peripheral neuropathy (Table 32-1). Of those, diabetic peripheral neuropathy (DPN) is the most common. It is estimated that more than 30% of all patients with diabetes have DPN.4, 5 Risk factors for the development of neuropathy include poor glycemic control, undiagnosed diabetes, smoking, excessive alcohol intake, renal failure, and low socioeconomic status.4, 6 Differing stages of DPN have been classified based on symptoms of numbness, tingling, burning, pins as well as needles, and electric shock (Table 32-2).4

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Table Graphic Jump Location
Table 32-1.Types of Peripheral Neuropathy3
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Table Graphic Jump Location
Table 32-2.Stages of Diabetic Peripheral Neuropathy4
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Complications of Diabetic Peripheral Neuropathy

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If untreated or treated suboptimally, DPN can lead to serious and debilitating complications including foot ...

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