Almost a quarter of diabetic patientsdevelop diabetic neuropathy which can be painful or painless. In painful diabetic neuropathy typically, patients complain of pain in stocking distribution, often burning & sharp pain. Pain increases in recumbent position, interrupting sleep & decreases with weight bearing. Patients life get affected involving the breakdown of affect, social support & self esteem.
Optimal control of all metabolic factors and regular organised surveillance of all people with diabetes is essential to reduce the risk of both development and progression of diabetic neuropathy and therefore reduce the risk of disability for the patient. Motor, sensory, and autonomic fibres may all be affected by diabetic neuropathy.
Treatment directed simply at the peripheral nerve is not useful. Medical management with different neuropathic drugs is helpful in most patients and interventional pain procedures like sympathetic blocks spinal cord stimulators in some intractable cases can be very helpful for these patients