Drug of choice in pain relief in diabetic neuropathy is -

Arts, is 'c'.i.e., Pregabalin Modalities used to treat painful diabetic neuropathyTreatment of diabetic neuropathyo A management algorithm outlined by a statement published in 2005 from the American Diabetes Association (ADA I recommended treatment in sequential steps ordered as follows:-o Exclude nondiabetic etiologieso Stabilize glycemic control (insulin not always required in type 2 diabetes)o Tricyclic drugs (eg, amitriptyline 25 to 150 mg before bed)o Anticonvulsants (eg, gabapentin, typical dose 1.8 gfday)o Opioid or opioid-like drugs (eg, tramadol or controlled release oxy>codone)o Consider pain clinic referralo The ADA statement noted that nonpharmacologic, topical, or physical therapies might be useful at any stage. These measures include acupuncture, capsaicin, glyceryl trinitrate spray or patches, and other therapies.o The American Academy of Neurology (AAN) performed a systematic review and published guidelines in 2011 for the treatment of painful diabetic neuropathy,o The following observations were made:o Preeabalin was regarded as effective.o A number of treatments were regarded as probably effective.GabapentinSodium valproateAmitriptylineDuloxetineVenlafaxineDextromethorphanMorphine sulphate, titrated Oxycodone, meanTramadolCapsaicinIsosorbide dinitrate sprayPercutaneous electrical nerve stimulation for three to four weeksLidocaine patch was regarded as possibly effective.o Treatments regarded as probably not effective by the AA Y were : -OxcarbazepineLamotrigineLacosamideClonidinePentoxifyllineMexiletine