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Diabetesneuropati

Senast uppdaterad: Senast reviderad:


Definition:
Nervskador som senkomplikation till diabetes, oftast i benen. 
Förekomst:
Upp till 50 % av personer med diabetes utvecklar diabetesneuropati.
Symtom:
Vanligast är symmetriska smärtor, dysestestier och minskad känsel (hypestesi).
Kliniska fynd:
Nedsatt känsel (monofilament, temperatur, vibrationssinne). Smärta vid beröring. 
Diagnostik:
Anamnes och klinisk undersökning är viktigast. I vissa fall kan provtagning och andra undersökningar övervägas. 
Behandling:
God metabol kontroll. Smärtbehandling med antidepressiva och antiepileptika i första hand. 
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  18. Wong MC, Chung JW, Wong TK. Effects of treatments for symptoms of painful diabetic neuropathy: systematic review. BMJ 2007; 335: 87. British Medical Journal  
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  21. SBU. Läkemedelsbehandling av vanliga smärttillstånd hos äldre personer. 2020-09-03 (Hämtad 2020-09-15). www.sbu.se  
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  24. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014 Jan 3;1:CD007115. DOI: 10.1002/14651858.CD007115.pub3. DOI  
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  29. Vinik AI, Shapiro DY, Rauschkolb C, et al. A randomized withdrawal, placebo-controlled study evaluating the efficacy and tolerability of tapentadol extended release in patients with chronic painful diabetic peripheral neuropathy. Diabetes Care. 2014;37(8):2302–2309.
  30. Mason L, Moore RA, Derry S, et al. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ 2004; 328: 991. British Medical Journal  
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  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas

Tidigare sakkunniga

  • Björn Eliasson, adjungerad professor och överläkare, Diabetescentrum, Sahlgrenska universitetssjukhuset, Göteborg