{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:46:58Z","timestamp":1792705618908,"version":"4.5.0"},"reference-count":170,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T00:00:00Z","timestamp":1550188800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Diabetic peripheral neuropathy (DPN) is the most common chronic complication of diabetes. It poses a significant challenge for clinicians as it is often diagnosed late when patients present with advanced consequences such as foot ulceration. Autonomic neuropathy (AN) is also a frequent and under-diagnosed complication unless it is overtly symptomatic. Both somatic and autonomic neuropathy are associated with increased mortality. Multiple clinical trials have failed because of limited efficacy in advanced disease, inadequate trial duration, lack of effective surrogate end-points and a lack of deterioration in the placebo arm in clinical trials of DPN. Multifactorial risk factor reduction, targeting glycaemia, blood pressure and lipids can reduce the progression of DPN and AN. Treatment of painful DPN reduces painful symptoms by about 50% at best, but there is limited efficacy with any single agent. This reflects the complex aetiology of painful DPN and argues for improved clinical phenotyping with the use of targeted therapy, taking into account co-morbid conditions such as anxiety, depression and sleep disturbance.<\/ns3:p>","DOI":"10.12688\/f1000research.17118.1","type":"journal-article","created":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T09:18:05Z","timestamp":1550222285000},"page":"186","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":32,"title":["An update on the diagnosis and treatment of diabetic somatic and autonomic neuropathy"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1789-6988","authenticated-orcid":false,"given":"Shazli","family":"Azmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis N.","family":"Petropoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Ferdousi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Ponirakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uazman","family":"Alam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-8903","authenticated-orcid":false,"given":"Rayaz A.","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2019,2,15]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"2285-93","DOI":"10.2337\/dc10-1303","article-title":"Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments.","volume":"33","author":"S Tesfaye","year":"2010","journal-title":"Diabetes Care."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"136-54","DOI":"10.2337\/dc16-2042","article-title":"Diabetic Neuropathy: A Position Statement by the American Diabetes Association.","volume":"40","author":"R Pop-Busui","year":"2017","journal-title":"Diabetes Care."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"150-4","DOI":"10.1007\/BF00400697","article-title":"A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population.","volume":"36","author":"M Young","year":"1993","journal-title":"Diabetologia."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"250-6","DOI":"10.2337\/diacare.24.2.250","article-title":"Simple screening tests for peripheral neuropathy in the diabetes clinic.","volume":"24","author":"B Perkins","year":"2001","journal-title":"Diabetes Care."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"937-44","DOI":"10.1111\/j.1464-5491.2012.03644.x","article-title":"Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications.","volume":"29","author":"W Herman","year":"2012","journal-title":"Diabet Med."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"439-50","DOI":"10.1016\/j.pain.2010.05.002","article-title":"Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): somatosensory abnormalities in 1236 patients with different neuropathic pain syndromes.","volume":"150","author":"C Maier","year":"2010","journal-title":"Pain."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"557-60","DOI":"10.2337\/diacare.17.6.557","article-title":"The prediction of diabetic neuropathic foot ulceration using vibration perception thresholds. 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