Peripheral neuropathy commonly occurs in long-standing diabetes mellitus that adversely affects the quality of life. Pregabalin (anticonvulsant) and duloxetine (antidepressant) remain popular drugs to manage diabetic peripheral neuropathic pain. The present study determined and compared the efficacy and safety of Pregabalin and duloxetine in diabetic peripheral neuropathic pain patients.

It confirmed diabetic peripheral neuropathy based on the history of diabetes mellitus and vibration perception threshold (VPT) using a biothesiometer (with the cut-off of 15 volts; VPT >15 volts was considered confirmatory for peripheral neuropathy). 

The study divided the patients equally into two groups and recorded their Baseline visual analog scale (VAS) score. It administered Tablet pregabalin 300 mg daily for four weeks to one group, while tablet duloxetine in 60 mg strength daily to the other group. It recorded and compared the VAS score after four-week treatment; and also observed the adverse events.

The study enrolled 86 patients with a mean age of 30 to 80 years. It described the Baseline characteristics, including mean age, mean BMI, and mean disease duration of duloxetine versus pregabalin group, as 50.30 ± 8.55 versus 48.20 ± 8.99 years, 23.47 ± 1.23 versus 23.10 ± 1.59 kg/m² and 21.64 ±7.41 versus 20.04±6.37 months respectively. Duloxetine effectively controlled peripheral neuropathic pain in 81.4% of patients and Pregabalin in 74.4%. The study observed severe drug-related adverse reactions in 4.6% of patients with duloxetine compared to 0% with Pregabalin.

Duloxetine and Pregabalin effectively reduce diabetes-related peripheral neuropathic pain. However, duloxetine has slightly better outcomes, while the safety profile of Pregabalin is better.

Cureus.2022;14(9): e28683. doi:10.7759/cureus.28683