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Diabetic Painful Peripheral Neuropathy (PPN)

Information

Painful peripheral neuropathy affects up to 10% of people with diabetes. Around half seek treatment. Characteristic features are burning, tingling and electric shocks in both feet, worse at night or on resting.

There is no correlation with degree of sensory loss.

Unilateral symptoms or pain on walking are not typical features, consider musculoskeletal sources or vascular disease.

Who can refer:

Any primary care clinician who has followed the primary care guidance and the patient still has significant symptoms

Who to refer:

Patients who have not responded to first line therapies

Who not to refer:

People with mechanical, referred or dysvascular pain. People without diabetes.

How to refer:

SCI Gateway, (patient will be seen by the consultant on the MDT clinic days at RIE only) or if all the possible first line therapies have been exhausted at the maximum tolerated dose, consider direct referral to a specialist pain clinic