Dr. Vera Bril, Director, Division of Neurology, UHN, is the lead author of the American Academy of Neurology's (AAN) new guidelines for the treatment of patients with painful diabetic neuropathy.

Vera Bril imageAccording to the Canadian Diabetes Association, more than 9 million Canadians live with diabetes or pre-diabetes. Diabetic nerve pain, or neuropathy, is caused by nerve damage and results in burning or tingling pain in the hands and feet. Symptoms usually begin 10 to 20 years after the diabetes diagnosis. Approximately 50% of people with diabetes will eventually develop nerve damage.

The new guidelines outline the most effective treatment for diabetic nerve pain. Dr. Bril conducted a comprehensive study of current medical research to help determine which treatments are most effective for this type of pain.  

"Diabetic nerve pain is often unreported and more often untreated," says Dr. Bril. "Evidence-based guidelines for the treatment of painful diabetic neuropathy were important to develop because painful diabetic neuropathy is a very common problem in our society and not properly handled by many caregivers for various reasons."

Dr. Bril found that several treatments are probably effective and should be considered, including certain seizure drugs, antidepressants and painkillers. Transcutaneous electric nerve stimulation, a widely used pain therapy using a portable device, was also found to be effective.

"These guidelines provide a framework for caregivers to help them understand what has been proven to work for patients with painful diabetic neuropathy and what the limitations are in treating their patients," said Dr. Bril. "The guidelines give direction in a field that is confusing since there are so many studies that have been published about treating painful diabetic neuropathy that it is difficult for any caregiver to sort through and evaluate them properly and then decide, based on good evidence, what they should offer to the patients."

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