Diabetic polyneuropathy
Not recommended
A single published RCT (Ziegler 2009) showed a modest improvement in subjective diabetic polyneuropathy symptoms with intravenous administration. The study has not been replicated in independent multicenter work since. International guidelines from 2024 and 2022 on painful diabetic neuropathy do not mention Actovegin; first-line options are pregabalin, gabapentin, duloxetine, and venlafaxine.