Pathways in the Diagnosis and Management of XXXX .

@entity1 @entity16 @entity3949 @entity305 @entity2412 @entity717
UNASSIGNED: Distal symmetric @entity305 (DSPN), the most common form of @entity3949 , has a complex pathophysiology and can be a major source of physical and @entity717 . The management of DSPN can be frustrating for both @entity1 and physician. This article provides a general overview of typical @entity1 pathways in DSPN, and highlights variations in diagnosis, management, and referral patterns among different providers. DSPN is managed in several settings by primary care physicians (PCPs), specialists, and nurse practitioners. The initial clinical management of the @entity1 is often dependent on the presenting complaint, the referral pattern of the provider, level of comfort of the PCP in managing @entity2412 , and geographic access to specialists. The primary treatment of DSPN focuses mainly on glycemic control and adjustment of modifiable risk factors, but other causes of @entity16 should also be investigated. Several pharmacologic agents are recommended by treatment guidelines, and as DSPN typically exists with comorbid conditions, a multimodal therapeutic approach should be considered. Barriers to effective management include failure to recognize DSPN, and misdiagnosis. @entity1 education also remains important. Referral patterns vary widely according to geographic location, access to services, provider preferences, and comfort in managing complex aspects of the disease. The variability in @entity1 pathways affects @entity1 education, satisfaction, and outcomes. Standardized screening tools, a multidisciplinary team approach, and treatment algorithms for @entity3949 should improve future care. To improve @entity1 outcomes, DSPN needs to be diagnosed sooner and interventions made before significant nerve damage occurs.
