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Treatment Algorithm for Painful
Diabetic Neuropathy
05 November 2004
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Confirm
diagnosis of diabetic neuropathy
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|
V
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Improve
glycemic control
|
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|
V
|
|
V
|
|
Oral
regimen
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Topical
regimen
|
|
|
V
|
|
V
|
|
Antidepressant:
amitriptyline,
nortriptyline, imipramine,
doxepin
|
Capsaicin
|
|
|
V
|
|
V
|
|
Anticonvulsant:
gabapentin,
carbamazepine, phenytoin
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Lidocaine
cream
|
|
|
V
|
|
V
|
|
Opiod
analgesic therapy
plus tramadol
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|
|
|
V
|
|
V
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|
Mexiletine
|
|
|
|
V
|
|
V
|
|
Refer
to pain clinic; consider spinal cord stimulation
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|
