PubMed · 15530622
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Ajit Singh Kashyap, Kuldip Parkash Anand, Surekha Kashyap, Abhijeet Anand. Peripheral neuropathy.. https://doi.org/10.1016/s0140-6736(04)17346-7
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Duloxetine is a balanced serotonin noradrenaline re-uptake inhibitor that has recently become the first agent to receive regulatory approval for the treatment of painful diabetic neuropathy in the US. This compound has no other significant receptor or channel activities other than the serotonin and noradrenaline re-uptake inhibition mechanisms and works to diminish or control the symptoms of diabetic neuropathy. Duloxetine has no known neuroprotective or other effects that prevent the development of neuropathy in patients with diabetes. Its effectiveness in diabetic neuropathy confirms the proposed role of serotonin and noradrenaline as key mediators of the descending pain inhibition pathways of the brain stem and spinal cord. Clinical studies have demonstrated the high degree of safety and efficacy for the compound with no adverse effects on glycaemic control due to the action of duloxetine being identified.
Diabetic neuropathy is a debilitating disorder that occurs in nearly 50 percent of patients with diabetes. It is a late finding in type 1 diabetes but can be an early finding in type 2 diabetes. The primary types of diabetic neuropathy are sensorimotor and autonomic. Patients may present with only one type of diabetic neuropathy or may develop combinations of neuropathies (e.g., distal symmetric polyneuropathy and autonomic neuropathy). Distal symmetric polyneuropathy is the most common form of diabetic neuropathy. Diabetic neuropathy also can cause motor deficits, silent cardiac ischemia, orthostatic hypotension, vasomotor instability, hyperhidrosis, gastroparesis, bladder dysfunction, and sexual dysfunction. Strict glycemic control and good daily foot care are key to preventing complications of diabetic neuropathy.
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