Treatment Algorithm for Neuropathic Pain after Exclusion of Nondiabetic Etiologies and Stabilization of Glycemic Control - Flowchart

Treatment Algorithm for Neuropathic Pain after Exclusion of Nondiabetic Etiologies and Stabilization of Glycemic Control - Flowchart

Treatment Algorithm for Neuropathic Pain after Exclusion of Nondiabetic Etiologies and Stabilization of Glycemic Control - Flowchart Diabetic Polyneuropathy Diabetic Polyneuropathy

«Flowchart»

Neuropathic pain

Neuropathic pain

Neuropathic pain

Yes

Yes

Yes

Diuretics, splinting, lidocaine patch, surgical unentrapment

Diuretics, splinting, lidocaine patch, surgical unentrapment

Diuretics, splinting, lidocaine patch, surgical unentrapment

Yes

Yes

Yes

Gabapentin/pregabalin

Gabapentin/pregabalin

Gabapentin/pregabalin

TCA/SNRI

TCA/SNRI

TCA/SNRI

Treatment combinations

Tramadol, oxcarbazepine, opioids, topicals

Treatment combinations

Tramadol, oxcarbazepine, opioids, topicals

Treatment combinations

Tramadol, oxcarbazepine, opioids, topicals

End

End

End

IVIg, steroids, Enbrel

IVIg, steroids, Enbrel

IVIg, steroids, Enbrel

Yes

Yes

Yes

No

No

No

TCA/SNRI

TCA/SNRI

TCA/SNRI

Gabapentin/pregabalin

Gabapentin/pregabalin

Gabapentin/pregabalin

Focal neuropathies

Focal neuropathies

Focal neuropathies

Diffuse neuropathies

Diffuse neuropathies

Diffuse neuropathies

IVIg, intravenous immune globulin; SNRI, serotonin-norepinephrine reuptake inhibitors; TCA, tricyclic antidepressants.

IVIg, intravenous immune globulin; SNRI, serotonin-norepinephrine reuptake inhibitors; TCA, tricyclic antidepressants.

IVIg, intravenous immune globulin; SNRI, serotonin-norepinephrine reuptake inhibitors; TCA, tricyclic antidepressants.

IVIg SNRI TCA

Gabapentin/pregabalin

Gabapentin/pregabalin

Gabapentin/pregabalin

Treatment targeted at pain mechanism

TCA contraindication

Treatment targeted at pain mechanism

TCA contraindication

TCA contraindication

Proximal neuropathies

Proximal neuropathies

Proximal neuropathies

Treatment targeted at pain mechanism

TCA contraindication

Treatment targeted at pain mechanism

TCA contraindication

Treatment targeted at pain mechanism

TCA contraindication

Yes

Yes

Yes

No

No

No