C08: Painful DPN: Assessment & Management

Up to half of people with diabetes develop neuropathy, and in roughly 30 to 40% of them it is painful. No drug modifies the underlying nerve disease, numbers needed to treat sit between about 4 and 10, and residual pain is the norm. A painful foot can also be an insensate, at-risk foot, so pain never stands in for protective sensation.

The module teaches describing and measuring the pain with a 0 to 10 scale and validated tools, screening mood and sleep, and excluding mimics. It sets a target of roughly 30 to 50% pain reduction with better sleep and function, then chooses among TCAs, SNRIs, gabapentinoids and sodium-channel blockers by comorbidity, tolerability, interactions and cost. It explains the OPTION-DM finding that adding a second agent helps partial responders, why opioids are not recommended, the place of capsaicin 8%, exercise and TENS, and how to read the SENZA-PDN spinal cord stimulation trial critically.

Content is tiered at Foundation, Core and Advanced level, with two algorithms and three case vignettes. You receive the Teaching Document, the Evidence Base, the slide deck and a narrated video.