MODERN TACTICS OF MANAGEMENT OF PATIENTS WITH DIABETIC POLYNEUROPATHY


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Abstract

Diabetic polyneuropathy (DPN) is one of the most common polyneuropathies. Issues of pathogenesis, early diagnosis and optimal treatment of DPN are under active discussion. This article focuses on the most common form of DPN - diabetic distal symmetric polyneuropathy (DDSPN). Modern view of the pathogenesis, diagnosis and treatment of DDSPN is presented. Glycemic control, educational program, lifestyle (diet, smoking cessation, maintenance or achievement of a normal body weight, therapeutic exercises, maintaining activities of daily living) and cognitive-behavioral therapy when indicated are effective ways to improve the course of diabetes mellitus and DDSPN. Significant successes was achieved in the pharmacotherapy of neuropathic pain in DDSPN, but this treatment does not slow down the process of peripheral nerve damage. Today special attention is paid to the search for pharmacotherapies aimed at changing the course of DDSPN. In Russia, α-lipoic acid, B vitamins, and of complex of B vitamins and biologically active substances are discussed as a possible pathogenetic therapy of DDSPN. Cocarnit is a complex preparation, containing vitamins B and metabolically active compounds. The prospects of the use of this drug are discussesd. The results of clinical studies of efficacy and safety of Cocarnit in patients with DDSPN are presented.

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About the authors

V. A Golovacheva

Department of Nervous Diseases and Neurosurgery of the Medical Faculty SBEI HPE "First MSMU n.a. I.M. Sechenov" of RMPH Moscow

V. A Parfenov

Department of Nervous Diseases and Neurosurgery of the Medical Faculty SBEI HPE "First MSMU n.a. I.M. Sechenov" of RMPH MD, Prof. Moscow

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