International Expert Consensus Conference

Recommendations for screening, diagnosis, and management of diabetic neuropathy in clinical practice

 

  • About 500 million adults worldwide are suffering from diabetes mellitus
    – with rising tendency.
    (1)
  • Roughly one in three patients is affected by diabetic neuropathy.(2)
  • About two thirds of patients with diabetic neuropathy are not aware of their disease.(3)
  • An international board of 15 neuropathy experts developed consensus recommendations and algorithms for screening, diagnosis, and management of diabetic neuropathy in clinical practice.

Diabetic neuropathy is one of the most frequent and severe complications of diabetes mellitus. Although it accounts for considerable morbidity, increased risk of mortality, and reduced quality of life, diabetic neuropathy still remains inadequately diagnosed and treated in practice. For this reason, an international board of 15 neuropathy experts met for a virtual conference on the occasion of the World Diabetes Day 2020 to develop consensus recommendations and algorithms for screening, diagnosis, and management of diabetic neuropathy in clinical practice. These recommendations have been published in September 2021 in the journal “Diabetes Research and Clinical Practice”.(4)

On this website Wörwag Pharma provides information on the current consensus recommendations for health care professionals. Wörwag Pharma is globally committed to prevention, early detection, and therapy of diabetic neuropathy.

Read the Consensus publication

What is diabetic neuropathy?

Diabetic neuropathy is defined as peripheral nerve dysfunction resulting from diabetes mellitus, after other causes of peripheral neuropathy have been excluded. Damage can occur in the somatic and/or autonomic components of the peripheral nervous system. Diabetic sensorimotor polyneuropathy (DSPN) is the most common form. It affects about 30 percent of diabetes patients and manifests in paresthesias, pain, numbness and/or reduced sensibility (deficits) occurring symmetrically in the feet and legs.

The chairmen of the consensus board, Prof. Dan Ziegler, Prof. Solomon Tesfaye and Prof. Andrew JM Boulton, summarize the most important facts of the consensus report. Watch the video here:

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Expert Interviews

Learn more about the background of the consensus conference in the expert interviews. Neuropathy experts answer relevant questions on diabetic neuropathy and the current recommendations.

Please click on the flag to read the interviews.

Asklepios Klinik Birkenwerder, BirkenwerderPD Dr. Alin O StirbanGermanyRead interviewInstitute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Dusseldorf, Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfProf. Dan ZieglerGermanyDiabetes Research Department, Sheffield Teaching Hospitals NHS Foundation Trust, SheffieldProf. Solomon TesfayeUnited KingdomRead interviewFaculty of Biology, Medicine and Health, University of Manchester and Manchester University Foundation Trust, ManchesterProf. Andrew JM BoultonUnited KingdomRead interview‘‘N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy ‘‘Carol Davila” BucharestProf. Gabriela RadulianRomaniaDepartment of Neurology, Harvard Medical School, Boston, MAProf. Roy FreemanUnited States of AmericaHo Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh CityProf. Khue Thy NguyenVietnamZayed Centre for Health Sciences, United Arab Emirates University, Al Ain, Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu DhabiProf. Juma Al KaabiUnited Arab EmiratesDepartment of Endocrinology, Federal Bureau of Medical and Social Expertise, Moscow, Department of Endocrinology, Russian Medical Academy of Continuous Professional Education, MoscowProf. Irina GurievaRussiaDepartment of Systems Medicine, Endocrinology Section, University of Rome Tor Vergata, RomeProf. Vincenza SpalloneItalyRead interviewNational Institute of Endocrinology and Diabetology, Lubochna, Faculty of Health Sciences University of Ss. Cyril and Methodius in TrnavaProf. Emil MartinkaSlovak RepublicDepartment of Endocrinology, Medical University - Sofia, SofiaProf. Tsvetalina TankovaBulgariaDepartment of Diabetology, National Medical Academy for Postgraduate Education, KievProf. Boris MankovskyUkraineRead interviewDepartment of Internal Medicine, Faculty of Medicine, University of Szeged, SzegedProf. Tamás VarkonyiHungaryDepartment of Internal Medicine, Faculty of Medicine, University of Szeged, SzegedProf. Péter KemplerHungary
Bulgaria
United Kingdom
USA
United Arab Emirates
Slovakia
Italy
Hungary
Germany
Ukraine
Romania
Vietnam
Russia
HungaryProf. Tamás Varkonyi

Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged Hungary

HungaryProf. Péter Kempler

Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged Hungary

GermanyPD Dr. Alin O Stirban

Asklepios Klinik Birkenwerder, Birkenwerder Germany

GermanyProf. Dan Ziegler

Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Dusseldorf, Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf GermanyRead interview

United States of AmericaProf. Roy Freeman

Department of Neurology, Harvard Medical School, Boston, MA United States of America

United KingdomProf. Andrew JM Boulton

Faculty of Biology, Medicine and Health, University of Manchester and Manchester University Foundation Trust, Manchester United KingdomRead interview

United KingdomProf. Solomon Tesfaye

Diabetes Research Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield United KingdomRead interview

SlovakiaProf. Emil Martinka

National Institute of Endocrinology and Diabetology, Lubochna, Faculty of Health Sciences University of Ss. Cyril and Methodius in Trnava Slovakia

UkraineProf. Boris Mankovsky

Department of Diabetology, National Medical Academy for Postgraduate Education, Kiev UkraineRead interview

RomaniaProf. Gabriela Radulian

‘‘N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy ‘‘Carol Davila” Bucharest Romania

BulgariaProf. Tsvetalina Tankova

Department of Endocrinology, Medical University - Sofia, Sofia Bulgaria

ItalyProf. Vincenza Spallone

Department of Systems Medicine, Endocrinology Section, University of Rome Tor Vergata, Rome ItalyRead interview

United Arab EmiratesProf. Juma Al Kaabi

Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi United Arab Emirates

RussiaProf. Irina Gurieva

Department of Endocrinology, Federal Bureau of Medical and Social Expertise, Moscow, Department of Endocrinology, Russian Medical Academy of Continuous Professional Education, Moscow Russia

VietnamProf. Khue Thy Nguyen

Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City Vietnam

Diabetic Neuropathy: Screening, diagnosis and management

Major symptoms of diabetic neuropathy

Clinical diagnosis of diabetic neuropathy is based on neuropathic symptoms and signs. Typical neuropathic symptoms include pain, paresthesias, and numbness particularly in the feet and calves.

Basic neurological assessment

The basic neurological assessment comprises the general medical and neurological history, inspection of the feet, and neurological examination to assess e.g., pain and sharp sensation and vibration sensation.

Three major principles in the treatment of diabetic neuropathy

    • Lifestyle modification
    • Optimal diabetes treatment
    • Multifactorial cardiovascular risk intervention
     
    • Pathogenetically oriented pharmacotherapy such as α-lipoic acid and benfotiamine

    Symptomatic treatment of neuropathic pain

    • Analgesic pharmacotherapy like antidepressants, anticonvulsants, opioids, capsaicin 8% patch and combinations 
    • Non-pharmacological options
     
    Highlights of the consensus publication

    Conscious of time? Read a professional page summary of all relevant contents.

    Highlights
     
    Consensus publication

    The consensus recommendations have been published in the international journal “Diabetes Research and Clinical Practice“, the official journal of the International Diabetes Federation (IDF).

    Access the paper
     

     

    Press Release

    The International Consensus Conference is a major milestone in the management of diabetic polyneuropathy.

    Read the press article here

    (1)IDF Diabetes Atlas 2021 – 10th edition; available online at www.diabetesatlas.org
    (2) Ziegler et al. Handb Clin Neurol. 2014;126:3-22.
    (3) Ziegler et al. Diabetes Res Clin Pract. 2018;139:147-154.
    (4) Ziegler et al. Diabetes Res Clin Pract. 2021 Sep 18:109063.