ABSTRACT
Diabetic peripheral sensory polyneuropathy is one of the most common ailments associated with diabetes. Painful diabetic peripheral neuropathy (DPN) is associated with substantial patient burden due to interference with daily function, especially in those with suboptimal pain management. The medical costs of DPN may account for up to 27% of the direct medical costs of diabetes, although the proportion due to pain is unclear. The diagnosis of DPN is based on the history. The pain may be spontaneous, continuous, or intermittent and is often worse at night. Visual inspection may reveal several abnormalities such as claw toes due to atrophy of the small intrinsic muscles, allowing unopposed action of the larger muscles. There are several neuropathic pain scales, such as the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale and the Neuropathic Pain Scale, that have been devised to aid the diagnosis. The pathophysiology of DPN is complex and not fully understood.
