Is Exercise Enough? Integrating Pharmacological and Physical Therapy Approaches in the Management of Diabetic Polyneuropathy - A Narrative Review.

Introduction: Diabetic polyneuropathy (DPN) is a prevalent complication of diabetes mellitus, significantly impacting quality of life through symptoms such as pain, sensory deficits, and motor impairments. Exercise therapy has emerged as a promising intervention for alleviating DPN symptoms by improving nerve function, muscle strength, and glucose control. However, the effectiveness of exercise alone in managing DPN remains uncertain, given the multifaceted nature of the condition. Objectives: This narrative review explores the current evidence on integrating pharmacological treatments and physical therapy approaches to enhance DPN management. The review evaluates the role of pharmacological agents, including analgesics, anticonvulsants, and neuroprotective drugs, in conjunction with exercise regimens. Additionally, it discusses the synergistic potential of combining physical therapy modalities such as strength training, aerobic exercise, and balance exercises with pharmacotherapy to improve overall outcomes. Results & Conclusion: While exercise plays a vital role in DPN management, a multimodal approach combining physical therapy with appropriate pharmacological treatments may offer superior benefits in reducing symptoms, preventing progression, and improving patients' quality of life. Further research is needed to define optimal therapeutic strategies and guidelines for integrated care.