Diabetic peripheral neuropathic pain (DPNP)
- Optimize diabetes + foot care, but glucose control does not reverse pain
- Duloxetine/pregabalin are established first-line options
- Gabapentin or TCA can be effective alternatives
- Topical capsaicin can help focal pain
- Avoid routine chronic opioid escalation
- Choose by sleep, mood, kidney + fall risk
Use at a glance
- Optimize diabetes + foot care, but glucose control does not reverse pain
Treatment options
- Duloxetine/pregabalin are established first-line options
Practical pearls
- Gabapentin or TCA can be effective alternatives
- Topical capsaicin can help focal pain
Escalation / refractory disease
- Avoid routine chronic opioid escalation
- Choose by sleep, mood, kidney + fall risk
Self-check
- What is first-line treatment for Diabetic peripheral neuropathic pain (DPNP)?
Duloxetine/pregabalin are established.
- What should generally be avoided in Diabetic peripheral neuropathic pain (DPNP)?
routine chronic opioid escalation.
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