An update on the treatment and management of diabetic peripheral neuropathy.

It is clear that the majority of the evidence for symptomatic management of DPN is for either TCAs or anticonvulsants. The Canadian Diabetes Association recommends agents from these classes as first-line therapy. Though these agents appear to be effective, the management of neuropathic pain is still quite difficult and many patients only achieve partial relief from therapy while others find no relief. It is important to focus on the prevention of onset and progression of diabetic neuropathy by dealing with the root of the problem, glycemic control. Patients should be educated on the importance of intensive glycemic control for the prevention of all diabetes complications, including peripheral neuropathy (Bril & Perkins, 2003).