Cilostazol for the treatment of distal symmetrical polyneuropathy in diabetes mellitus: Where do we stand?

Introduction: Diabetic Neuropathy (DN) is one of the most frequent chronic complications of diabetes mellitus. Its commonest form, distal symmetrical polyneuropathy (DSPN), is characterised by slowly progressing length-dependent nerve damage in the lower limbs, increasing the risk of foot ulcerations and leading to symptoms like tingling, pain, or numbness. Aim: The aim of this review was to discuss the utility of cilostazol, a phosphodiesterase inhibitor with known antiplatelet, vasodilatory, anti-inflammation properties, in the treatment of DSPN. Results: Preclinical studies in animals have demonstrated the ability of cilostazol to improve nerve function and to protect from peripheral nerve disruption and central sensitisation. However, clinical trials in humans are very sparse and have so far not been encouraging. Conclusions: Further research is needed to fully understand the mechanisms and potential efficacy of cilostazol in treating DSPN.