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
- Which drugs are established first-line DPNP options?
Duloxetine/pregabalin. - Which escalation pattern is avoided in DPNP?
Routine chronic opioid escalation.
Drugs used for this (5)
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