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Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy is a complication of diabetes resulting in damage to nerves in the extremities. Sometimes it can be the first sign of diabetes and can affect 60-70% of persons with the disease. It typically affects the feet first and occurs in a “stocking-glove” distribution. Both the sensory and motor nerves can be affected, and often leads to loss of balance, numbness and burning pain. The primary treatment is optimal control of blood sugar levels. Painful diabetic neuropathy can be treated with a variety of medications including duloxetine and pregabalin. Other antidepressants and anticonvulsants can be effective as well. Perineural platelet rich plasma injections may be effective treatment for the pain and numbness. Spinal cord stimulation has recently gained FDA approval for treatment of painful diabetic peripheral neuropathy.