PENDAHULUAN

Menurut Federasi Diabetes Internasaional, sekitar 382 juta orang di dunia menderita
diabetes, salah satu penyebab utama neuropati. Polineuropati According to the
International Diabetes Federation, 382 million people worldwide are currently affected by
diabetes[1], one of the leading causes of neuropathy [2]. The distal symmetrical
polyneuropathy (DSPN) is the commonest clinical form of diabetic neuropathy, affecting
more than 90% of the patients [3].(1) Foot ulceration and painful neuropathy are the main
clinical consequences of DSPN, linked with higher morbidity and mortality [4]. Frequently,
patients look for medical help only when pain appears [5], a symptom that affects 10% to
26% of this population[6,7].(1)

. A number of symptomatic treatments are recommended in clinical guidelines for the

management of painful DPN, including antidepres

sants such as amitriptyline and duloxetine, the γ-aminobutyric acid analogues gabapentin and
pregabalin, opioids, and topical agents such as capsaicin. However, monotherapy is frequently not
effective in achieving complete resolution of pain in DPN. (2)