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To provide evidence-based guidelines for the management of painful diabetic peripheral neuropathy (PDN), an expert panel convened and identified 79 relevant articles out of more than 2000 citations. The panel used the standard classification in adjudicating study quality. In addition, they defined a short list of preferred outcome measures for quantifying pain reduction. The main findings were as follows:
Pregabalin is established as effective (evidence level A).
Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and controlled-release oxycodone), topical capsaicin, isosorbide dinitrate spray, and percutaneous electrical stimulation are probably effective (level B).
Other treatments have less-ro…