ABSTRACT
The main goals of treatment for diabetic peripheral neuropathy pain (DPNP) symptoms are primary prevention and symptom management. Prior to initiating care, practitioners and patients should establish endpoints for treatment. If practitioners and patients are not in agreement from the outset, frustration, misunderstandings, and false expectations may occur. When pain reduction is the goal, the amount of reduction should be mutually determined and quantifiable: 30%, 50%, or 75% within 1, 2, or 3 months of treatment. If absolute pain elimination is not expected from the treatment, practitioners must clarify this with patients. Failing to communicate the intent of therapy inevitably leads to patient dissatisfaction, inappropriate use of medication, unsanctioned dose escalations, ‘doctor-shopping’, and other troublesome behaviors. As with other aspects of diabetes mellitus (DM) management, patients must be empowered to ‘self-manage’ their own care.
