Management of neuropathic pain in people with diabetes has been widely investigated. However, little attention was paid to address ischemic-related pain in patients with diabetes mellitus who suffered from chronic limb-threatening ischemia (CLTI), the end stage of lower extremity arterial disease (LEAD). Pain management has a tremendous influence on patients’ quality of life and prognosis. Poor management of this type of pain owing to the lack of full understanding undermines patients’ physical and mental quality of life, which often results in a grim prognosis, such as depression, myocardial infarction, lower limb amputation, and even mortality. In the present article, we review the current strategy in the pain management of diabetes-related CLTI. The endovascular therapy, pharmacological therapies, and other optional methods could be selected following comprehensive assessments to mitigate ischemic-related pain, in line with our current clinical practice. It is very important for clinicians and patients to strengthen the understanding and build intervention strategy in ischemic pain management and possible adverse consequence.

中文翻译：

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糖尿病相关慢性肢体威胁性缺血患者的疼痛管理


糖尿病患者神经性疼痛的治疗已得到广泛研究。然而，很少有人关注患有慢性肢体威胁性缺血（CLTI）（下肢动脉疾病（LEAD）的末期）的糖尿病患者的缺血相关疼痛。疼痛管理对患者的生活质量和预后具有巨大影响。由于缺乏充分认识而对此类疼痛处理不善，会损害患者的身心生活质量，往往导致预后不良，如抑郁、心肌梗死、下肢截肢，甚至死亡。在本文中，我们回顾了当前糖尿病相关 CLTI 疼痛管理策略。综合评估后可以选择血管内治疗、药物治疗和其他可选方法来减轻缺血相关的疼痛，符合我们目前的临床实践。对于临床医生和患者来说，加强对缺血性疼痛管理和可能的不良后果的认识并制定干预策略非常重要。