Semaglutide and Diabetic Neuropathy: Guideline Summary

Patient Assessment and Monitoring

• The American Diabetes Association recommends identifying high-risk patients for treatment-induced neuropathy of diabetes (TIND) with pre-existing symptomatic neuropathy when initiating semaglutide 1
• Baseline neuropathy assessment is mandatory, including 10-g monofilament testing for loss of protective sensation, vibration sensation with 128-Hz tuning fork, pinprick or temperature sensation, and documentation of existing neuropathic symptoms, as recommended by the American Diabetes Association 1

Management of Diabetic Neuropathy

• The American Diabetes Association suggests initiating neuropathic pain management immediately with pregabalin or duloxetine as first-line agents if new or worsening neuropathy occurs during rapid glycemic improvement 3
• Gabapentin is recommended as an alternative first-line option for neuropathic pain management, according to the American Diabetes Association 3

Foot Care

• The American Diabetes Association recommends daily foot self-examination to detect lesions early, proper footwear at all times, and annual comprehensive foot evaluation with monofilament testing for patients on semaglutide with diabetes 5, 6, 1