Evidence map›Paper›PMID 32918837›Full record

ReviewJournal of diabetes investigation2021

Current concepts in the management of diabetic polyneuropathy.

Dan Ziegler, Nikolaos Papanas, Oliver Schnell, Bich Dao Thi Nguyen, Khue Thy Nguyen, Kongkiat Kulkantrakorn, Chaicharn Deerochanawong

Open access · goldAbstract readReview
In one paragraph

Review in Journal of diabetes investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 4 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Alpha-lipoic acid for diabetic peripheral neuropathy.The Cochrane database of systematic reviews · 2024
    Pooled it
  5. Trial
  6. Article
  7. Review
  8. Article
  9. The success-failure inversion in modern medicine.Frontiers in public health · 2026
    Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Review
  16. Review
  17. Fruit-Based Diet and Gut Health: A Review.Food science & nutrition · 2025
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 7 institutions in 4 countries.

Dan ZieglerInstitute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.ORCID https://orcid.org/0000-0001-8956-3552
Nikolaos PapanasDiabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Oliver SchnellForschergruppe Diabetes e.V at the Helmholtz Center, Munich-Neuherberg, Germany.
Bich Dao Thi NguyenEndocrinology and Diabetes Unit, Tam Duc Heart Hospital, Ho Chi Minh City, Vietnam.
Khue Thy NguyenHo Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Kongkiat KulkantrakornFaculty of Medicine, Thammasat University, Pathumthani, Thailand.
Chaicharn DeerochanawongDiabetes and Endocrinology Unit, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Democritus University of Thrace · GRDeutsches Diabetes-Zentrum e.V. · DEHCMC Hospital of Dermato Venereology · VNHelmholtz Zentrum München · DERajavithi Hospital · THThammasat University · THUniversity of Medicine and Pharmacy at Ho Chi Minh City · VN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Diabetic sensorimotor polyneuropathy (DSPN) is encountered in approximately one-third of people with diabetes. This, in turn, might markedly impoverish their quality of life, mainly owing to neuropathic pain and foot ulcerations. Painful DSPN might be as frequent as 25% in diabetes patients. Symptoms as a result of DSPN typically comprise pain, paresthesia and numbness in the distal lower limbs. Asymptomatic DSPN might reach 50% among patients with this condition. Unfortunately, DSPN is still not adequately diagnosed and treated. Its management has three priorities: (i) lifestyle improvement, near-normoglycemia and multifactorial cardiovascular risk intervention; (ii) pathogenesis-oriented pharmacotherapy; and (iii) symptomatic alleviation of pain. Intensive diabetes therapy showed evidence for favorable effects on the incidence and deterioration of DSPN in type 1 diabetes, but not type 2 diabetes. Among pathogenesis-oriented treatments, α-lipoic acid, actovegin, benfotiamine and epalrestat are currently authorized to treat DSPN in several countries. Symptomatic therapy uses analgesics, notably antidepressants, opioids and anticonvulsants, reducing pain by ≥50% in approximately 50% of individuals, but might be limited, particularly by central nervous system-related adverse events. Local treatment with the capsaicin 8% patch might offer an alternative. In addition to pain relief, therapy should improve sleep, mobility and quality of life. In conclusion, multimodal treatment of DSPN should consider the individual risk profile, pathogenetic treatment and pain management using pharmacotherapy (combinations, if required), as well as non-pharmacological options.

Indexed as

Diabetic NeuropathiesDisease ManagementHumansMolecular Targeted TherapyNeuralgiaDiabetic polyneuropathyDiagnosisPharmacotherapy

Identifiers

PMID32918837
PMCPMC8015839
OpenAlexW3086665044

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.