and gene modulation following pregabalin and duloxetine combination for painful diabetic polyneuropathy.

Diabetic peripheral neuropathy (DPN) induces chronic neuropathic pain in diabetic patients. Current treatments like pregabalin and duloxetine offer limited efficacy. This study evaluates combining pregabalin and duloxetine versus pregabalin alone for DPN pain relief, and explores gene modulation ( and ) to understand neuropathic pain's molecular basis. Diabetic patients with DPN were randomized into groups receiving combination therapy or pregabalin alone for 4 weeks. Pain intensity, gene expression and quality of life were assessed. Combination therapy significantly reduced pain, improved quality of life and upregulated and genes compared with monotherapy. Pregabalin and duloxetine combination therapy in DPN led to mRNA upregulation and negative correlation of gene expression with pain scores. This combination therapy effectively reduced pain and improved quality of life. CTRI/2021/02/031068.