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Painful diabetic neuropathy — ABFM Board MCQ

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HardEndocrine/MetabolicPainful diabetic neuropathyABFM Board

A 60-year-old woman with diabetes has burning foot pain and numbness. A1c is 8.1%, B12 is normal, and monofilament testing is reduced bilaterally. Pedal pulses are present and there are no ulcers. Which of the following would you advise this patient?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Duloxetine or pregabalin

Painful diabetic peripheral neuropathy can be treated with duloxetine, pregabalin, gabapentin, or selected tricyclics. Foot care, glycemic optimization, and ulcer prevention remain essential.

Reference: ADA Standards of Care in Diabetes, 2026