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The results of these studies suggest that opioids should be included among the therapeutic options for painful DSPN, provided that careful selection of patients unresponsive to standard treatments, regular monitoring, appropriate dose titration, and management of possible opioid-specific problems (analgesic misuse or addiction, tolerance, opioid-induced hyperalgesia) are ensured

Further research remains warranted to address unanswered questions, such as whether DN results from global metabolic reprogramming of the PNS and how energy transfer or toxic byproducts between nerve cells contribute to the disease

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10.1093/femsec/fiu002 322
