OBJECTIVE Considerable evidence implicates impaired nitric oxide (NO) generation in the pathogenesis of diabetic neuropathic pain. We therefore conducted a pilot study to examine the effects of isosorbide dinitrate (ISDN), a NO donor with local vasodilating properties, in spray form in the management of chronic neuropathic pain. RESEARCH DESIGN AND METHODS The study was of double-blind, rando...

OBJECTIVE The pathogenesis of painful diabetic neuropathy (PDN) is not clear. Following our in vivo observations of increased sural nerve epineurial blood flow in patients with PDN, we investigated the cutaneous microcirculation of the foot by laser Doppler flowmetry to determine if the epineurial findings were just confined to the nerve or more widespread in other vascular beds. RESEARCH DES...

Wewould like to congratulate Veves et al. for their excellent review that stressed the importance of painful diabetic neuropathy diagnosis [1]. However, apart from neuropathic pain scales and skin biopsy, we believe that neurophysiological tools are also useful in the diagnostic work-up of diabetic patients with neuropathic pain complaints due to small fiber involvement. Small fiber function ca...

Methodology Ninety consecutive patients at a university hospital in Manaus, Amazonas were included in this study. Eighty-six (95.6%) had type 2 diabetes, 66.7% were female, mean age was 56.2±12.8 yrs.-old and mean time of diabetes diagnosis was 11.5±9.5 yrs. They were evaluated using Michigan Neuropathy Screening Instrument (MNSI) and the clinical component of the Michigan Diabetic Neuropathy S...

Diabetic peripheral neuropathy (DPN) is a frequent complication of diabetes and a major cause of morbidity and increased mortality. It is typically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful diabetic neuropathy (P-DPN) is a common phenotype of DPN that affects up to one-third of the general diabetic populati...

Diabetic neuropathy is a common form of peripheral neuropathy, yet the mechanisms responsible for pain in this disease are poorly understood. Alterations in the expression and function of voltage-gated tetrodotoxin-resistant (TTX-R) sodium channels have been implicated in animal models of neuropathic pain, including models of diabetic neuropathy. We investigated the expression and function of T...

abstract  introduction: hyperalgesia is considered as one the marked signs of subchronic diabetes mellitus that could affect the life style of the patients. with c onsidering the potential anti-diabetic effect of the medicinal plant withania somnifera (ws)( ashwagandha), this study was designed to investigate the analgesic effect of ws on formalin-induced nociceptive responses (standard formali...

T he antifungal agent itraconazole is considered safe in patients with diabetes (1,2) but has been associated with acute painful neuropathy in patients taking vincristine (3–5). We describe a patient with diabetic neuropathy who developed acute painful neuropathy with itraconazole therapy. A 37-year-old man with poorly controlled type 1 diabetes of 19 years' duration presented with an excematou...

In a recent letter by Davis and Smith (1), venlafaxine HCl was reported to be effective in the symptomatic treatment of patients with painful diabetic neuropathy. This observation is in accordance with a similar finding made by us. We administered venlafaxine HCl in 8 patients who had unremitting painful peripheral diabetic neuropathy that did not respond to conventional analgesia. All patients...

OBJECTIVE To study the efficacy of lamotrigine in relieving the pain associated with diabetic neuropathy. METHODS The authors randomly assigned 59 patients to receive either lamotrigine (titrated from 25 to 400 mg/day) or placebo over a 6-week period. Primary outcome measure was self-recording of pain intensity twice daily with a 0 to 10 numerical pain scale (NPS). Secondary efficacy measures...