π Peripheral Neuropathy: What Clinicians Should Know π§ β‘
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Peripheral neuropathy affects ~1% of adults worldwide, with diabetes accounting for more than half of all cases. The JAMA review highlights why length-dependent patterns dominate, how metabolic stress injures long axons first, and why sensory symptoms outpace motor loss. Evidence-based evaluation still begins with glucose testing, vitamin B12 with methylmalonic acid, and serum protein electrophoresis.
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First-line therapies for neuropathic pain β gabapentin, pregabalin, duloxetine, and tricyclics β offer meaningful but often incomplete relief, reminding us that prevention and risk factor modification remain central.
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A clear, elegant synthesis of mechanisms, diagnostics, and management β essential reading for anyone caring for patients with numbness, tingling, or burning feet. π£β¨