Diabetic Neuropathy

Question 1

Which of the following is the most effective first-line treatment for managing his symptoms of Diabetic Neuropathy?

Answer 1

duloxetine, gabapentin, pregabalin or amitriptyline.

Question 2

What is the key factor in the pathogenesis of diabetic neuropathy?

Answer 2

Chronic hyperglycaemia

Question 3

Which of the following is the most appropriate next step in the management of this patient?

Answer 3

Duloxetine

Question 4

National Institute for Health and Care Excellence (NICE) guidelines advise that painful diabetic neuropathy should be managed as with any other neuropathic pain condition.

First-line medications include duloxetine, gabapentin, pregabalin or amitriptyline. If one is ineffective a trial of one of the three other medications is indicated.

The patient’s glycemic control should also be addressed with a review of his lifestyle habits and oral medication for diabetes.

Given the HbA1c of 72 mmol/mol, he is likely to require an intensification of his diabetic medication.

Answer 4

National Institute for Health and Care Excellence (NICE) guidelines advise that painful diabetic neuropathy should be managed as with any other neuropathic pain condition.

First-line medications include duloxetine, gabapentin, pregabalin or amitriptyline. If one is ineffective a trial of one of the three other medications is indicated.

The patient’s glycemic control should also be addressed with a review of his lifestyle habits and oral medication for diabetes.

Given the HbA1c of 72 mmol/mol, he is likely to require an intensification of his diabetic medication.

Question 5

Which of the following treatments is the first-line treatment of diabetic neuropathy?

Answer 5

Pregabalin

Question 6

What would be the most appropriate first line treatment in this situation?

Answer 6

Stabilise blood glucose levels