Abstract
Diabetes mellitus (DM) is a very common comorbidity worldwide, and it is associated with a wide variety of complications. Diabetic peripheral neuropathy (DPN) is one of these complications that increases the morbidity and mortality of these patients. Multiple studies indicated that lifestyle modifications are very beneficial for these patients in terms of decreasing the symptoms or preventing the progression of the disease. Therefore, a thorough search was conducted to study and shed light on the effects of lifestyle interventions, such as physical exercise, and pharmacological treatment on DPN. A total of 100 studies were found and 32 were selected based on whether or not they support the aim of the study. It was concluded that lifestyle interventions such as regular exercise, healthy diet and weight loss, which will all in turn improve the patient’s glycemic control, play a major role in controlling the disease and preventing its complications. Moreover, the aim of pharmacological interventions is a 30% reduction in pain intensity, however pharmacological interventions are limited in DPN, up till now the FDA approved only three medications that help in the reduction of the pain intensity. These medications are antidepressant duloxetine, anticonvulsant pregabalin, and the opioid-like analgesic tapentadol.
Highlights
By 2017, approximately 451 million adults were affected by Diabetes Mellitus (DM) worldwide, and this huge number is expected to increase up to around 690 million adults by 2045 [1,2]
The most common complication of diabetes is Diabetic peripheral neuropathy (DPN) as it affects about half of all cases with diabetes mellitus [3]
66% of insulin dependent diabetes mellitus patients had some form of neuropathy as per a population-based cohort study done by Dyck PJ et al [3]
Summary
By 2017, approximately 451 million adults were affected by Diabetes Mellitus (DM) worldwide, and this huge number is expected to increase up to around 690 million adults by 2045 [1,2]. DPN is defined as “the presence of signs and/or symptoms of peripheral nerve dysfunction in diabetic patients after exclusion of other causes” [4]. Symptoms of this disease include neuropathic pain and reduced sensation which in turn will lead to a lot of complications that would eventually impair and restrict the daily life of the patients [6,7]. DM is considered the most common cause of non-traumatic lower limb amputation in the United Kingdom (UK) [10] It poses a tremendous financial burden on hospitals and healthcare systems, since the total annual cost required to manage DPN symptoms and its complications such as amputation in the US is approximately between $4.6 and $13.7 billion [11]
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