Studies show that opioids are the number one prescribed medication for peripheral neuropathy contrary to evidence suggesting a lack of efficacy. Despite being a common condition for individuals with diabetes, treatment is often non-evidence based, meaning that creating a care plan can be difficult. With this, the American Academy of Neuropathy (AAN) was urged to re-evaluate treatment recommendations for Diabetic Neuropathy Pain (DNP). Listen in as Dr. John Swegle, a pain management expert, and host Geoff Wall discuss the updates on DNP treatment recommendations. 

The GameChanger:

• AAN guidelines reaffirmed that opioids should not be used in the treatment of DNP
• More appropriate treatments for DNP would include gabapentinoids, TCAs, and SNRIs
• SNRI, especially venlafaxine dosing should be targeted to achieve the norepinephrine effects of the drug class
• For patients wishing for natural therapy regimens, gingko may be considered 

Show Segments:

00:00 – Introductions

02:05 – The American Academy of Neuropathy Guideline Update

05:29 – Treating and Controlling Diabetes

06:27 – Comparing Gabapentinoids, Sodium Channel Blockers, SNRIs, Opioids, and TCAs

12:30 – The GameChanger 

19:29 – The American Academy of Neuropathy Recommendations

24:49 – Closing Remarks 

Guest Bios:

John Swegle, PharmD, BCPS, BCACP Clinical Associate Professor University of Iowa College of Pharmacy

John received his PharmD degree from the University of Iowa. He currently is a Clinical Associate Professor with the University of Iowa and clinical pharmacist with the Mercy Family Medicine Residency Program. In addition, he works with Hospice of North Iowa serving as a consultant pharmacist and as a faculty member for the Mercy Medical Center – North Iowa Palliative Medicine Fellowship.

Links to Resources:

• American Academy of Neuropathy – Oral and Topical Treatment of Painful Diabetic Polyneuropathy: Practice Guideline Update Summary
• Healthcare Claim Study – Opioids in Peripheral Neuropathy

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Learning Objectives: 

1. Select an appropriate first line medication for diabetic neuropathic pain (DNP) based on the 2022 guidelines

2. Describe the treatment effects of the drugs used for DNP in the 2022 guidelines

Dr. Wall is a member of the Janssen Speaker's Bureau. 

Dr. John Swegle reports no actual or potential conflicts of interest associated with this episode.

Continuing Education Information:

0.05 CEU | 0.5 Hrs

ACPE UAN: 0107-0000-22-057-H01-P

Initial release date: 01/03/22

Expiration date: 01/03/2023

Additional CPE & CME details can be found here.

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