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Abstract:  Diabetic neuropathy refers to a large number of clinical syndromes affecting both the autonomic and peripheral nervous systems and both type 1 and type 2 diabetes patients. In this article, the authors place particular emphasis on the use of ketamine Pluronic lecithin organogels for treating diabetic neuropathy. They also discuss the etiology of diabetic neuropathy, its clinical presentation, pain management (glycemic control, tricyclic antidepressants, anticonvulsants, ketamine and autonomic agents) and provide three brief case reports describing the use of a polymedicine formula . They conclude that medications administered by transdermal gels are a viable option and potentially the most rewarding for a compounding pharmacist, as they allow pain relief with fewer adverse effects. The real challenge is deciding whether the patient should begin with the polymedicine formula or with ketamine 10% and amitriptyline 2%, with additional ingredients added as needed to determine the optimal combination of medications for analgesic effects. More research is needed to determine the best combination of agents.

Related Keywords: diabetic neuropathy, burning pain, allodynia, hyperpathia, glycemic control, tricyclic antidepressants, gabapentin, ketamine, NMDA receptor antagonist, phantom limb pain, clonidine, baclofen

Related Categories: DIABETES, WOUND CARE

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