Understanding painful symptomatic diabetic neuropathy

Neuropathic pain is a common and disabling condition affecting a significant number of diabetic patients with distal polyneuropathy. Fluctuations in blood glucose levels have been shown to exacerbate neuropathic pain and initial treatment should therefore focus on achieving tight glycaemic control. The role of patient education is achieving greater importance and a patient's understanding of diabetic complications and their causes can significantly improve outcomes. Nevertheless, the majority of patients require some form of treatment in order to effectively manage their pain. There are a number of therapeutic agents available, such as the tricyclic drugs which have been used with good effect for years, but also more recent additions, such as gabapentin, which is now licensed for the treatment of neuropathic pain. Copyright © 2004 John Wiley & Sons, Ltd.